栓塞剂选择与通过导管动脉栓塞治疗结肠管出血后的并发症之间的关联
Takatoshi Kubo1, Hayato Yamana2,3, Shotaro Aso4
1Department of Radiology, The University of Tokyo Hospital, Bunkyo-ku, Japan. kubo.tky@gmail.com.
European radiology
|December 19, 2025
概括
凝海绵颗粒增加了经过透气管动脉栓塞 (TAE) 进行结肠分流动脉出血 (CDB) 后的再出血和缺血风险. N-丁-2-烯酸盐减少了复出血,但增加了缺血症,而线圈提供了平衡.
科学领域:
- 干预性放射学 干预性放射学
- 胃肠病学 胃肠病学
- 血管外科 血管外科
背景情况:
- 透气管动脉栓塞 (TAE) 是结肠分管出血 (CDB) 的首要治疗方法.
- 有限的比较数据存在于CDB的TAE中使用的不同栓塞剂的结果.
研究的目的:
- 为了评估选择栓塞剂与早期再出血和CDB的TAE后肠道缺血之间的关联.
- 为了比较卷轴的安全性和有效性,凝海绵 (GS) 颗粒和n-丁-2-烯酸盐 (NBCA) 在TAE中用于CDB.
主要方法:
- 全国范围的回顾性队列研究使用日本诊断程序组合数据库 (2010年7月 - 2022年3月).
- 包括5625名成年患者,他们使用线圈,GS颗粒或NBCA进行了首次CBDTAE.
- 多变量后勤回归分析,调整为共变量和医院内部集群以评估结果.
主要成果:
- 在59%的案例中使用了线圈,在30%的案例中使用了GS粒子,在11%的案例中使用了NBCA.
- 与线圈相比,GS颗粒与早期再出血 (OR 1.38) 和肠道缺血 (OR 2.64) 的更高几率有关.
- NBCA与早期再出血的几率较低 (OR 0.69),但肠道缺血的几率较高 (OR 3.53).
结论:
- 凝海绵颗粒增加了 CDB 的 TAE 后早期再出血和肠道缺血的风险.
- N-丁-2-烯酸与降低再出血,但增加缺血风险有关.
- 在CDB中选择TAE的栓塞剂应根据患者复出血与缺血的风险因素进行个性化选择.
相关概念视频
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
277
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...
277
Venous Thrombosis III: Interprofessional Care
262
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...
262
Inflammatory Bowel Disease I: Ulcerative Colitis
859
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
859
Pulmonary Embolism III: Nursing Management
320
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
320
Venous Thrombosis I: Introduction
294
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
294
Aneurysm II: Clinical Manifestations and Diagnostic Studies
218
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
218

