急诊经肱动脉入路行胸廓内动脉栓塞术治疗大咯血

发布时间：2018-06-06 20:53

本文选题：咯血 + 肱动脉　；参考：《中国介入影像与治疗学》2016年04期

【摘要】：目的探讨经肱动脉入路行胸廓内动脉(ITA)急诊栓塞治疗大咯血的疗效。方法回顾性分析13例经肱动脉入路行ITA栓塞术治疗大咯血的临床资料。选用明胶海绵条、聚乙烯醇(PVA)颗粒及弹簧圈选择性栓塞出血的动脉,对动脉造影的表现及治疗结果进行总结及评价。结果 13例患者共找到并成功栓塞13支病变的ITA。经股动脉入路选择失败的原因:6例因锁骨下动脉扭曲严重,7例因ITA开口变异。出血动脉造影主要表现为增粗,分支增多、紊乱及新生血管形成。3例患者栓塞止血后行病变肺叶切除术。所有患者术后随访1年均无再次咯血。结论对于怀疑有ITA出血但经股动脉入路选择困难的大咯血患者,肱动脉入路可作为很好的技术补充手段。
[Abstract]:Objective to investigate the effect of emergency embolization of internal thoracic artery via brachial artery approach for massive hemoptysis. Methods Clinical data of 13 patients with massive hemoptysis underwent ITA embolization via brachial artery approach were retrospectively analyzed. Selective embolization of haemorrhagic arteries with gelatin sponge, polyvinyl alcohol PVA (PVA) granules and coils was used to summarize and evaluate the findings and therapeutic results of arteriography. Results 13 patients were found and successfully embolized 13 branches of ITAA. The reason for the failure of transfemoral approach was that 6 cases were due to severe distortion of subclavian artery and 7 cases were due to ITA variation. The main manifestations of hemorrhage arteriography were thickening, branching, disorder and neovascularization. 3 patients underwent pulmonary lobectomy after embolization and hemostasis. All patients were followed up for 1 year without recurrent hemoptysis. Conclusion the brachial approach can be used as a good supplementary technique for patients with severe hemoptysis who are suspected to have ITA hemorrhage but who are difficult to select via femoral artery approach.
【作者单位】：哈尔滨医科大学第二附属医院介入科;
【分类号】：R459.7

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