Percutaneous Transarterial Embolization of Iatrogenic Giant Pseudoaneurysm of Superior Gluteal Artery

因醫療引起的巨大上臀動脈偽動脈瘤的經皮動脈栓塞術

蔡建中(Chien-Chung Tsai) ； 韓淑珍(Shu-Jen Han) ； 牟聯瑞(Lein-Ray Mo) ； 黃華思(Hwa-Szu Hwang)

《中華放射線醫學雜誌》 22卷2期 (1997/04) Pp. 83-86

摘要

本篇文章的目的是報告一例因後方腸骨取得骨移植物的骨科手術所造成的上臀動脈偽動脈瘤病人。於他院開刀後一週發現在臀部有一突起的腫塊，而被診斷為血塊，之後疼痛加劇且不能平躺，因而轉介到本院就醫。經電腦斷層檢查發現，左邊臀部的位置有一顯影很好的腫塊，經由選擇性血管攝影證實為偽動脈瘤。
利用三毫米大的彈簧線圈，進行高選擇性的治療性栓塞，成功地完成栓塞後，病人症狀立即得到舒緩。電腦斷層攝影則發現偽動脈瘤已有血栓的產生。由此我們得到一個結論，術後如有發現逐漸長大的腫塊，應高度懷疑偽動脈瘤的產生，血管攝影則可來確定診斷。

關鍵字

動脈瘤 ； 髂動脈 ； 動脈 ； 治療性栓塞 ； 手術 ； 併發症

並列摘要

The purpose of this article is to report a case of giant pseudoaneurysm of the left superior gluteal artery that resulted after an orthopedic surgeon took a bone graft from the left iliac bone. This pseudoaneurysm was treated with arterial embolization. A bulging mass at the left buttock was noted by the patient a week after the surgery and was diagnosed as hematoma by the surgeon. The pain became severe that the patient could not remain in a supine position. CT findings of a well defined enhancing mass at the left gluteal area was confirmed by selective angiography as a pseudoaneurysm of the left superior gluteal artery. Superselective therapeutic embolization using a 3 mm coil spring emboli was carried out. Immediate relief of the symptoms was noted after successful coil embGlization. Follow-up CT scan revealed thrombus formation at the pseudoaneurysm. We therefore conclude that there is a high index of suspicion of pseudoaneurysm in a patient with an enlarging mass noted after surgery. Angiography must be performed to confirm the diagnosis. Coil spring embolization is an effective method in the management of a pseudoaneurysm.

並列關鍵字

Aneurysm, iliac ； Arteries, therapeutic blockade ； Surgery, complications