[1]王晓东,Salvatore JA Sclafani.血管介入108例创伤性动静脉瘘的介入诊疗分析[J].介入放射学杂志,2010,(07):521.
 WANG Xiaodong,Endovascular diagnosis and therapy for traumatic arteriovenous fistulas:an analysis of 108cases[J].journal interventional radiology,2010,(07):521.
点击复制

血管介入108例创伤性动静脉瘘的介入诊疗分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2010年07期
页码:
521
栏目:
心脏介入
出版日期:
2010-07-15

文章信息/Info

Title:
Endovascular diagnosis and therapy for traumatic arteriovenous fistulas:an analysis of 108cases
作者:
王晓东Salvatore JA Sclafani
100142北京大学临床肿瘤学院、北京肿瘤医院及北京市肿瘤防治研究所介入治疗科(王晓东,现于纽约州立大学下州医疗中心访问学者);美国纽约州立大学下州医疗中心及Kings County医疗中心放射科(Salvatore JA Sclafani )
Author(s):
WANG Xiao-dong
Salvatore JA Sclafani.Department of Interventional Therapy,School of Oncology,Peking University,Beijing Cancer Hospital&Institute,Beijing100142,China.
关键词:
创伤性AVF血管造影介入治疗
分类号:
R543.5
文献标志码:
A
摘要:
目的分析创伤性动静脉瘘(AVF)的临床特点、造影表现、造影技术及治疗方式的选择。方法回顾性分析纽约Kings County医疗中心25年间全部确诊的108例创伤性AVF的介入相关诊疗资料。分析内容包括患者外伤种类、临床表现、损伤部位、血管造影异常特征、AVF血流动力学特征(分5个类型)、治疗方式的选择等。结果108例患者中共发现117处AVF,大多数患者临床特征不明确。创伤种类包括枪伤(导致72处AVF)、刺伤(24处)、钝性伤(8处)、高处坠落伤(3处)、医源性损伤(2处)。损伤部位常见于肢体(46例)、颈部(19例)、肝脏(13例)和锁骨下血管(11例)。所有病变均可见静脉早显,显示动脉横断52处,撕裂37处,49.6%的AVF与假性动脉瘤有关。最常见的血流特点是Ⅰ型,即瘘口所在的动脉近段和远段、静脉的近段和远段都显示,伴远侧段静脉瓣功能不全,共40处瘘(34.2%),其次是Ⅲ型22个(18.8%),Ⅴ型最不常见(4.3%)。34例接受手术治疗,61例栓塞治疗,7例临床观察。分别采用弹簧圈(47例)、明胶海绵(9例)、无水乙醇(3例)、可脱球囊(2例),其中弹簧圈效果理想、并发症少。6例采用覆膜支架效果好。结论血管造影是诊断创伤性AVF的金标准,造影时准确观察动脉损伤的性质,瘘口的解剖和血流特点及所有进入瘘口的动脉分支,对于选择治疗方式及保证介入治疗的成功完成至关重要。

参考文献/References:

[1]Weng CF,Wei J,Lee YT,et al.High-output heart failure resulting from an obscure traumatic arteriovenous fistula[J].J Chin Med Assoc,2008,71:428-430.
[2]Shindo S,Honda Y,Katsu M,et al.Recovery of cardiomegaly after treatment of traumatic popliteal arteriovenous fistula[J].Circ J,2009,73:776-778.
[3]Anderson CA,Strumpf RK,Diethrich EB.Endovascular management of a large post-traumatic iliac arteriovenous fistula:utilization of a septal occlusion device[J].J Vasc Surg,2008,48:1597-1599.
[4]Sclafani SJ,Cooper R,Shaftan GW,et al.Arterial trauma :diagnostic and therapeutic angiography[J].Radiology,1986,161:165-172.
[5]Cohen JE,Rajz G,Gomori JM,et al.Urgent endovascular stent-graft placement for traumatic penetrating subclavian artery injuries[J].J Neurol Sci,2008,272,151-157.
[6]刘作勤,唐军,左玉宽,等.血管内栓塞治疗创伤性椎AVF(附4例报告)[J].医学影像学杂志,2002,12:362-363.
[7]Sancak T,Bilgic S,Ustuner E.Endovascular stent-graft treatment of a traumatic vertebral artery pseudoaneurysm and vertebrojugular fistula[J].Korean J Radiol,2008,9Suppl :S68-72.
[8]Hii HP,Wu ZH,Yeh ML ,et al.Successful coil embolization of an unusual aorto-superior mesenteric vein fistula[J].J Vasc Surg,2009,49:1310-1312.
[9]Koc O,Cil BE,Peynircioglu B,et al.Complementary use of NBCA with the Amplatzer vascular plug for embolization of a high-flow traumatic hepatic arteriovenous fistula[J].Cardiovasc Intervent Radiol,2009,32:1105-1107.
[10]Keeling AN,Naughton PA,Leahy AL,et al.Traumatic inferior gluteal artery pseudoaneurysm and arteriovenous fistula managed with emergency transcatheter embolization[J].Cardiovasc Intervent Radiol,2008,31Suppl 2:S135-139.
[11]Wu CG,Li YD,Li MH.Post-traumatic superior mesenteric arteriovenous fistula:Endovascular treatment with a covered stent [J].J Vasc Surg,2008,47:654-656.
[12]王精兵,程永德.重视覆膜支架在外周血管病中的应用[J].介入放射学杂志,2007,16:577-579.
[13]王茂强,李生,谢春明.创伤性肾动静脉瘘的介入治疗[J].中华创伤杂志,2004,20:273-276.

相似文献/References:

[1]杨 亮,姚双龙,胡世兵,等.创伤性颈动脉假性动脉瘤行覆膜支架植入治疗1例 [J].介入放射学杂志,2021,30(07):747.
 YANG Liang,YAO Shuanglong,HU Shibing,et al.Successful treatment of traumatic carotid pseudoaneurysm with covered stent implantation: report of one case[J].journal interventional radiology,2021,30(07):747.

备注/Memo

备注/Memo:
收稿日期:2010-03-02
更新日期/Last Update: 2010-07-15