Interlock可解脱弹簧圈在脾动脉瘤腔内治疗中的应用

目的:探究Interlock可解脱弹簧圈在脾动脉瘤的腔内治疗中的应用价值。方法:回顾性分析2016年2月至2019年2月于本中心使用Interlock可解脱弹簧圈治疗的36例脾动脉瘤患者的临床资料,包括10例男性,26例女性,31例真性动脉瘤,5例假性脾动脉瘤,术前均行超声或CTA明确诊断。术中栓塞后,立即血管造影以明确技术成功率。围手术期及术后2周、3个月和6个月监测血常规、胰淀粉酶和主动脉CTA,观察并发症的发生情况。结果:6例患者弹簧圈栓塞动脉瘤远近端及瘤腔,其余仅栓塞脾动脉瘤瘤腔。术中DSA血管造影提示即刻脾动脉瘤栓塞闭塞率为97%以上,术中共使用128枚Interlock弹簧圈,其中104枚为钻石型,24枚为普通2D型。弹簧圈平均直径为6.3±4.2(2-12)mm,平均长度为16±13.5(3-32)mm,瘤体平均尺寸为40.6±12.5(15-70) mm。围手术期无并发症发生。平均随访10.0±3.2(6-15)个月,1月后2例出现脾梗死,7例发生轻微腹痛及低热等症状,所有病例均未见瘤腔再通和瘤体增大。结论:Interlock可解脱弹簧圈可以安全有效地治疗脾动脉瘤,但其远期疗效需长期随访观察。

Application Value of Interlock Detachable Coils in the Endovascular Therapy for Splenic Artery Aneurysm

ABSTRACT Objective: To investigate the application value of Interlock detachable coils for the endovascular treatment of splenic aneurysms. Methods: The clinical data of 36 patients with splenic aneurysms treated with Interlock detachable coils from February 2016 to February 2019 were retrospectively analyzed, including 10 cases of male, 26 cases of female, 31 cases of true aneurysms. 5 cases of pseudo splenic aneurysm were diagnosed by ultrasound or CTA preoperation. An angiogram was performed immediately after embolization to determine the technical success rate. The blood routine, pancreatic amylase and aortic CTA were monitored during the perioperative period and at 2 weeks, 3 months and 6 months after surgery to observe the incidence of complications. Results: 6 patients underwent embolization of the aneurysm at the proximal end and the tumor cavity, and the rest only embolized the spleen aneurysm tumor cavity. Intraoperative DSA angiography showed that the occlusion rate of the splenic aneurysm was higher than 97%. A total of 128 Interlock coils were used during the operation, of which 104 were diamond-shaped and 24 were ordinary 2D. The average diameter of the coils is 6.3±4.2 (2-12) mm, the average length is 16±13.5 (3-32) mm, and the average size of the tumor is 40.6±12.5 (15-70) mm. No complications occurred during the perioperative period. The average follow-up was 10.0±3.2 (6-15) months. After 1 month, 2 cases had spleen infarction, 7 cases had mild abdominal pain and low fever. In all cases, no tumor cavity recanalization and tumor enlargement were observed. Conclusion: Interlock can release the coils safely and effectively for the treatment of splenic aneurysms. It has a wide application prospect and its long-term efficacy needs long-term follow-up observation.