Đánh giá hiệu quả can thiệp nội mạch trong điều trị phình mạch tạng sau chấn thương

To evaluate the effectiveness of endovascular intervention for treatment of traumatic visceral pseudoaneurysms

SUMMARY

Background: Visceral pseudoaneurysm was rare condition, its complication of bleeding led to severe clinical scenario, causing blood loss shock and death. Surgery was an invasive treatment and had high rate of morbidity and mortality; therefore, endovascular intervention has gradually becoming an alternative treatment nowadays.

Objectives: To evaluate the safety and effectiveness of endovascular treatment in patients with traumatic visceral pseudoaneurysms.

Materials and Methods: All patients were diagnosed of traumatic visceral pseudoaneurysm and treated by endovascular intervention at Cho Ray Hospital from October 2017 to February 2019.

Results: Thirty (30) patients were enrolled in this study. Locations of pseudoaneurysm were as follows: hepatic arteries (22.2%), gastroduodenal arteries (5.6%), renal arteries (55.5%), splenic arteries (8.3%), superior mesenteric arteries (5.6%) and left gastric arteries (2.8%). The embolic agents included Histoacryl glue (NCBA) (6%), coils (82%), PVA particles + coils (6%) and gelfoam + coils (6%). 94.4% of pseudoaneurysms were completely embolized, and 90% of patients recovered of clinical status at discharge. No severve complications were reported and the most common complication was hematoma (5%) at puncture site.

Conclusion: Endovascular treament is an effective and safe method in the management of traumatic visceral pseudoaneurysms.

Keywords: traumatic visceral pseudoaneurysm, endovascular treatment, safety, effectiveness