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投稿时间：2025-11-19 网络发布日期：2026-03-04
投稿时间：2025-11-19 网络发布日期：2026-03-04
中文摘要: 目的 分析内脏动脉瘤（VAA）的介入治疗及中远期疗效，为临床选择合适的介入治疗方案提供参考。方法 收集2017年1月至2024年10月于江苏省中医院及东部战区总医院接受介入治疗的67例VAA患者的临床资料进行回顾性分析。根据瘤体解剖特征及血流动力学特点，分别采用单纯瘤腔填塞术（57例）、旷置隔绝法联合瘤腔填塞术（4例）、单纯裸支架植入术（3例）和支架辅助瘤腔填塞术（3例）。术后即刻造影，采用 Raymond分级评估瘤腔闭塞情况。术后第 6、12 个月行数字减影血管造影（DSA）或 CT 血管成像（CTA）复查，观察瘤腔大小变化及封闭情况、载瘤动脉和支架是否通畅、实质脏器是否发生梗死等并发症情况。结果 67例患者共发现VAA 76枚，其中真性动脉瘤68枚，假性动脉瘤8枚。瘤体直1.2~5.6（2.19±0.75）cm。所有患者介入治疗技术总成功率为100%，68枚（89.5%）瘤体达到RaymondⅠ级栓塞，8枚（10.5%）达到Ⅱ级栓塞，无Ⅲ级栓塞病例。手术时间（49.7±21.4）min，住院时间（4.0±3.0）d。围手术期并发症包括栓塞后综合征6例、脾梗死3例、胸腔积液1例，经对症治疗后均恢复。术后随访12~84（32.4±16.7）个月，随访期间无瘤体破裂、复发、增大或治疗相关死亡病例，支架通畅率维持100%。结论 介入治疗VAA安全有效，需结合瘤体部位、形态及血流动力学特征选择个体化术式。
Abstract:Objective To analyze the interventional treatment and medium to long-term efficacy of visceral artery aneurysm（VAA），and to provide a reference for clinical selection of appropriate interventional treatment options.Methods A retrospective analysis was conducted on the clinical data of 67 VAA patients who underwent interventional treatment in Jiangsu Province Hospital of Chinese Medicine and General Hospital of Eastern Theater Command from January 2017 to October 2024. According to the anatomical characteristics and hemodynamic characteristics of the aneurysms，57 cases were treated with simple aneurysm sac embolization，4 cases with endovascular exclusion combined with aneurysm sac embolization，3 cases with simple bare stent implantation，and 3 cases with stent-assisted aneurysm sac embolization. Immediate post-operative angiography was performed，and the Raymond classification was used to evaluate the aneurysm sac occlusion. Digital subtraction angiography（DSA）or computed tomography angiography（CTA）reexamination was performed at the 6th and 12th months after the operation to observe changes in the size and closure of the aneurysm sac，patency of the parent artery and stent，and complications such as infarction of solid organs. Results A total of 76 VAAs were found in 67 patients，including 68 true aneurysms and 8 pseudoaneurysms. The aneurysm diameter was 1.2-5.6（2.19±0.75）cm. The total technical success rate of interventional treatment for all patients was 100%，68 aneurysms（89.5%）achieved Raymond class Ⅰ occlusion，8 aneurysms（10.5%）achieved class Ⅱocclusion，and there was no class Ⅲ occlusion case. The operation time was（49.7±21.4）min，and the hospitalization time was（4.0±3.0）days.Perioperative complications included post- embolization syndrome in 6 cases，splenic infarction in 3 cases，and pleural effusion in 1 case，all of which recovered after symptomatic treatment. The follow-up period after surgery was 12-84（32.4±16.7）months. There were no cases of aneurysm rupture，recurrence，enlargement，or treatment-related death during the follow-up，and the stent patency rate remained at 100%. Conclusion Interventional treatment for VAA is safe and effective，requiring individualized procedures based on aneurysm location，morphology，and hemodynamic characteristics.
keywords: Visceral artery aneurysm Interventional therapy Coil embolization Stent assisted Individualized treatment
文章编号： 中图分类号：R543.5 R459.9 文献标志码：A
基金项目:国家自然科学基金青年科学基金项目（82302321）
附件
引用文本：
徐向贤,刘丽,郭山峰,等.内脏动脉瘤个体化介入治疗方式的选择及疗效分析[J].中国临床研究,2026,39(2):247-251.
徐向贤,刘丽,郭山峰,等.内脏动脉瘤个体化介入治疗方式的选择及疗效分析[J].中国临床研究,2026,39(2):247-251.