Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANG Xiquan , GE Shitang , CHEN Zhong , DOU Shubin , LU Shengyue , WANG Xin

Interventional Endovascular Treatment Center, No. 960 Hospital of PLA, Zibo, Shandong 255300, P. R. China;

Corresponding author：

ZHANG Xiquan, Email: jrkzxq@163.com

Keywords：

visceral artery aneurysm; interventional therapy; bare stent; covered stent; coil

DOI：

10.7507/1007-9424.201811007

Video：

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Objective To investigate treatment methods and effect of endovascular interventional therapy for visceral artery aneurysms.Methods The clinical data of 32 patients with visceral artery aneurysms, who were treated in the No. 960 Hospital of PLA from February 2011 to April 2018, were retrospectively analyzed. It was proveded by the CT or digital subtraction angiography before the interventional therapy. The implantation of covered stent, coil embolization together with stent implantation, double stents placement or pure coil embolization were performed. The postoperative antithrombotic therapy was adopted in the patients accepted the stent implantation. The CT angiography was performed on the month of 1, 6, 12, 24 or the patient was uncomfortable after the treatment to evaluate the obstruction condition of the aneurysms, stent blood flow, and branches arteries, etc..Results The success rate of the endovascular interventional therapy was 100%. In the 11 patients underwent the implantation of covered stent, the postoperative angiography showed that the stent lumen was patent and the aneurysm was not visualized. In the 9 patients underwent the coil embolization together with stent implantation and 3 patients underwent the double stents placement, the postoperative angiography results of the aneurysm showed that it was faintly visualized and the branch arteries were not involved. In the 9 patients underwent the pure coil embolization, the postoperative angiography showed that the aneurysm was not visualized. No perioperative mortality or procedure related complications occurred. No case was lost during the follow-up of a median period of 25.5 (6–48) months. During the follow-up, one patient developed the mild abdominal pain in one month, which disappeared after the symptomatic medication management. Except for 1 patient developed the mild stent stenosis (<30%) on the 12th month after the procedure, the stent and the branch arteries of the other patients were completely patent, and no aneurysms recurred.Conclusion For treatment of visceral artery aneurysms, endovascular interventional therapy is safe and effective and shows an excellent short-term and mid-term effects.

Citation： ZHANG Xiquan, GE Shitang, CHEN Zhong, DOU Shubin, LU Shengyue, WANG Xin. Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 307-311. doi: 10.7507/1007-9424.201811007 Copy

1.	郭伟, 卫任. 内脏动脉瘤腔内治疗进展. 中国血管外科杂志 (电子版), 2012, 4(3): 129-132.
2.	Tessier DJ, Abbas MA, Fowl RJ, et al. Management of rare mesenteric arterial branch aneurysms. Ann Vasc Surg, 2002, 16(5): 586-590.
3.	Mohan IV, Stephen MS. Peripheral arterial aneurysms: open or endovascular surgery? Prog Cardiovasc Dis, 2013, 56(1): 36-56.
4.	景在平, 宋超, 陆清声. 内脏动脉瘤腔内治疗的现状及问题. 中华普通外科杂志, 2012, 27(7): 521-522.
5.	张希全, 葛世堂, 朱伟, 等. 自发性孤立性肠系膜上动脉夹层的血管腔内介入治疗体会. 中国普外基础与临床杂志, 2017, 24(4): 449-452.
6.	Acosta S, Asciutto G. Endovascular therapy for visceral artery aneurysms. Int Angiol, 2016, 35(6): 573-578.
7.	Carroccio A, Jacobs TS, Faries P, et al. Endovascular treatment of visceral artery aneurysms. Vasc Endovascular Surg, 2007, 41(5): 373-382.
8.	孙小杰, 胡何节, 王晓天, 等. 内脏动脉瘤 41 例治疗分析. 中国血管外科杂志 (电子版), 2017, 9(1): 32-36.
9.	Gehlen JM, Heeren PA, Verhagen PF, et al. Visceral artery aneurysms. Vasc Endovascular Surg, 2011, 45(8): 681-687.
10.	Regus S, Lang W. Rupture risk and etiology of visceral artery aneurysms and pseudoaneurysms: a single-center experience. Vasc Endovascular Surg, 2016, 50(1): 10-15.
11.	张萌帆, 韩新巍, 张凯, 等. 覆膜支架和密网支架在复杂内脏动脉瘤的治疗应用 (附 12 例病例分析). 临床放射学杂志, 2015, 34(2): 267-270.
12.	Dorigo W, Pulli R, Azas L, et al. Early and intermediate results of elective endovascular treatment of true visceral artery aneurysms. Ann Vasc Surg, 2016, 30: 211-218.
13.	Ruhnke H, Kröncke TJ. Visceral artery aneurysms and pseudoaneurysms: retrospective analysis of interventional endovascular therapy of 43 aneurysms. Rofo, 2017, 189(7): 632-639.
14.	黄骏咏, 冯家煊, 冯睿, 等. 血管腔内治疗腹腔干动脉瘤 16 例效果分析. 介入放射学杂志, 2016, 25(6): 491-495.
15.	张伟, 张曦彤, 田玉龙, 等. 不锈钢弹簧圈填塞治疗内脏动脉瘤 8 例. 介入放射学杂志, 2016, 25(4): 308-311.
16.	史岩鹏, 王东林, 刘金朝. 内脏动脉瘤血管腔内治疗方法和效果探讨. 当代医学, 2014, 20(34): 65-66.
17.	刘凌晓, 颜志平, 王建华, 等. 经导管介入治疗内脏动脉瘤 (附 65 例报道). 复旦学报 (医学版), 2011, 38(3): 216-220, 246.
18.	Rabellino M, García-Nielsen L, Zander T, et al. Stent-assisted coil embolization of a mycotic renal artery aneurysm by use of a self-expanding neurointerventional stent. Cardiovasc Intervent Radiol, 2011, 34(Suppl 2): S109-S112.
19.	林文晓, 郭平凡, 蔡方刚. 28 例内脏动脉瘤的治疗体会. 福建医科大学, 2014.
20.	郭建明, 谷涌泉, 俞恒锡, 等. 腔内与开放手术治疗腹腔干及其分支动脉瘤疗效对比分析. 中国实用外科杂志, 2013, 33(12): 1031-1033, 1037.
21.	Zhang W, Fu YF, Wei PL, et al. Endovascular repair of celiac artery aneurysm with the use of stent grafts. J Vasc Interv Radiol, 2016, 27(4): 514-518.
22.	Augsburger L, Farhat M, Reymond P, et al. Effect of flow diverter porosity on intraaneurysmal blood flow. Klin Neuroradiol, 2009, 19(3): 204-214.
23.	常光其, 王冕. 多层裸支架治疗累及分支动脉的主动脉病变的思考. 中华外科杂志, 2015, 53(11): 805-808.
24.	Zhang Y, Lu Q, Zhao Z, et al. Multiple overlapping uncovered stents as an alternative flow-diverting strategy in the management of peripheral and visceral aneurysms. J Vasc Surg, 2014, 60(5): 1209-1217.
25.	Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.

1. 郭伟, 卫任. 内脏动脉瘤腔内治疗进展. 中国血管外科杂志 (电子版), 2012, 4(3): 129-132.
2. Tessier DJ, Abbas MA, Fowl RJ, et al. Management of rare mesenteric arterial branch aneurysms. Ann Vasc Surg, 2002, 16(5): 586-590.
3. Mohan IV, Stephen MS. Peripheral arterial aneurysms: open or endovascular surgery? Prog Cardiovasc Dis, 2013, 56(1): 36-56.
4. 景在平, 宋超, 陆清声. 内脏动脉瘤腔内治疗的现状及问题. 中华普通外科杂志, 2012, 27(7): 521-522.
5. 张希全, 葛世堂, 朱伟, 等. 自发性孤立性肠系膜上动脉夹层的血管腔内介入治疗体会. 中国普外基础与临床杂志, 2017, 24(4): 449-452.
6. Acosta S, Asciutto G. Endovascular therapy for visceral artery aneurysms. Int Angiol, 2016, 35(6): 573-578.
7. Carroccio A, Jacobs TS, Faries P, et al. Endovascular treatment of visceral artery aneurysms. Vasc Endovascular Surg, 2007, 41(5): 373-382.
8. 孙小杰, 胡何节, 王晓天, 等. 内脏动脉瘤 41 例治疗分析. 中国血管外科杂志 (电子版), 2017, 9(1): 32-36.
9. Gehlen JM, Heeren PA, Verhagen PF, et al. Visceral artery aneurysms. Vasc Endovascular Surg, 2011, 45(8): 681-687.
10. Regus S, Lang W. Rupture risk and etiology of visceral artery aneurysms and pseudoaneurysms: a single-center experience. Vasc Endovascular Surg, 2016, 50(1): 10-15.
11. 张萌帆, 韩新巍, 张凯, 等. 覆膜支架和密网支架在复杂内脏动脉瘤的治疗应用 (附 12 例病例分析). 临床放射学杂志, 2015, 34(2): 267-270.
12. Dorigo W, Pulli R, Azas L, et al. Early and intermediate results of elective endovascular treatment of true visceral artery aneurysms. Ann Vasc Surg, 2016, 30: 211-218.
13. Ruhnke H, Kröncke TJ. Visceral artery aneurysms and pseudoaneurysms: retrospective analysis of interventional endovascular therapy of 43 aneurysms. Rofo, 2017, 189(7): 632-639.
14. 黄骏咏, 冯家煊, 冯睿, 等. 血管腔内治疗腹腔干动脉瘤 16 例效果分析. 介入放射学杂志, 2016, 25(6): 491-495.
15. 张伟, 张曦彤, 田玉龙, 等. 不锈钢弹簧圈填塞治疗内脏动脉瘤 8 例. 介入放射学杂志, 2016, 25(4): 308-311.
16. 史岩鹏, 王东林, 刘金朝. 内脏动脉瘤血管腔内治疗方法和效果探讨. 当代医学, 2014, 20(34): 65-66.
17. 刘凌晓, 颜志平, 王建华, 等. 经导管介入治疗内脏动脉瘤 (附 65 例报道). 复旦学报 (医学版), 2011, 38(3): 216-220, 246.
18. Rabellino M, García-Nielsen L, Zander T, et al. Stent-assisted coil embolization of a mycotic renal artery aneurysm by use of a self-expanding neurointerventional stent. Cardiovasc Intervent Radiol, 2011, 34(Suppl 2): S109-S112.
19. 林文晓, 郭平凡, 蔡方刚. 28 例内脏动脉瘤的治疗体会. 福建医科大学, 2014.
20. 郭建明, 谷涌泉, 俞恒锡, 等. 腔内与开放手术治疗腹腔干及其分支动脉瘤疗效对比分析. 中国实用外科杂志, 2013, 33(12): 1031-1033, 1037.
21. Zhang W, Fu YF, Wei PL, et al. Endovascular repair of celiac artery aneurysm with the use of stent grafts. J Vasc Interv Radiol, 2016, 27(4): 514-518.
22. Augsburger L, Farhat M, Reymond P, et al. Effect of flow diverter porosity on intraaneurysmal blood flow. Klin Neuroradiol, 2009, 19(3): 204-214.
23. 常光其, 王冕. 多层裸支架治疗累及分支动脉的主动脉病变的思考. 中华外科杂志, 2015, 53(11): 805-808.
24. Zhang Y, Lu Q, Zhao Z, et al. Multiple overlapping uncovered stents as an alternative flow-diverting strategy in the management of peripheral and visceral aneurysms. J Vasc Surg, 2014, 60(5): 1209-1217.
25. Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases

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