超动脉栓塞使用伊米佩内姆/西拉斯治疗慢性疼痛的阿基里斯肌病 耐腐蚀的保守管理
Neeraj Kumar1, Niraj Nirmal Pandey1, Sanjeev Kumar1
1Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.
Journal of vascular and interventional radiology : JVIR
|October 17, 2025
概括
超动脉栓塞 (TAE) 为慢性阿基里斯肌病 (AT) 疼痛提供安全有效的解决方案,这种疼痛对传统治疗无反应. 这种微创手术显著减少疼痛,改善功能,为患者提供持久的缓解.
科学领域:
- 干预性放射学 干预性放射学
- 肌肉骨医学 肌肉骨医学
- 血管干预 血管干预
背景情况:
- 慢性阿基里斯肌病 (AT) 是一个重大的临床挑战,经常被证明是对保守的管理策略的耐药性.
- 持续的疼痛和AT的功能限制会对患者的生活质量产生负面影响.
研究的目的:
- 评估跨动脉栓塞 (TAE) 的可行性,安全性和有效性,以管理抗非手术治疗的慢性阿基里斯肌病 (AT).
- 评估TAE作为反抗性AT的潜在治疗选择.
主要方法:
- 一项前性研究涉及18名患者 (20个四肢) 慢性AT不响应保守护理至少3个月.
- 超选择性栓塞的高血管化的动脉分支供给受影响的阿基里斯肌区域使用伊米佩内姆/西拉斯和对比剂.
- 使用视觉模拟尺度 (VAS) 和维多利亚体育评估研究所-阿基里斯 (VISA-A) 评分评估的疼痛和功能在手术前和手术后长达12个月.
主要成果:
- 在90%的手术中 (18/20个四肢) 实现了针对性动脉分支栓塞的技术成功.
- 从基线观察到,VAS疼痛得分显著降低 (中位数为7至1,P<.0001),VISA-A功能得分有所改善 (中位数为29.5至68,P=.0001),持续到1年.
- 临床成功,定义为>50%的VAS减少,在94.44%的治疗四肢中实现.
结论:
- 超动脉栓塞 (TAE) 是慢性阿基里斯肌病 (AT) 的可行且安全的干预性放射技术.
- TAE在减轻疼痛和改善AT耐保守治疗的患者的功能方面表现出显著的有效性.
- 该程序与不良事件的低风险相关,提供了一个有前途的替代治疗选择.
相关概念视频
Peripheral Artery Disease III: Interprofessional Care
237
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
237
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
311
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
311
Pericarditis III: Medical Management
307
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
307
Venous Thrombosis III: Interprofessional Care
278
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
278
Angina IV: Management
235
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
235
Aneurysm III: Interprofessional Care
254
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
254


