급성 늑간 동맥 출혈의 경동맥 색전 치료 = Transarterial Embolization of Acute Intercostal Artery Bleeding

다국어 초록 (Multilingual Abstract)

Purpose: To report our experiences of transarterial embolization for acute intercostal artery bleeding.
Materials and Methods: A retrospectively analysis of the causes, clinical manifestations, angiographic findings and transarterial embolization technique in 8 patients with acute intercostal artery bleeding, with a review of the anatomical basis.
Results: The causes of intercostal artery bleeding were iatrogenic and traumatic in 88 and 12% of cases, respectively. Active bleeding from the collateral intercostal or posterior intercostal arteries was angiographically demonstrated in 75 and 25% of cases, respectively. Transarterial embolization successfully achieved hemostasis in all cases. However, two patient with hypovolemic shock expired due to a massive hemothorax, despite successful transarterial embolization.
Conclusion: Intercostal access should be performed through the middle of the intercostal space to avoid injury to the collateral intercostal artery. Transarterial embolization is an effective method for the control of intercostal artery bleeding.

국문 초록 (Abstract)

목적 : 급성 늑간동맥 출혈을 경동맥 색전 치료한 사례를 분석하였다.
대상과 방법: 혈관조영술상 늑간동맥출혈이 확인된 8예를 대상으로(남:여= 6:2, 29-77세, 평균 58세), 원인, 출혈부위, 혈관조영 소견, 치료 방법, 치료 결과 및 환자의 임상경과 등을 후향적으로 분석하였다.
결과: 늑간동맥 출혈의 원인은 모두 의인성(88%) 이나 외상성(12%) 이었다. 출혈부위는 늑골의 상연을 따라 주행하거나 늑간을 가로지르는 부행늑간동맥(collateral intercostal artery)인 경우가 75%였고, 후늑간동맥(posterior intercostal artery)인 경우가 25%였다. 전 예에서 경동맥 색전술로 성공적으로 지혈 하였지만, 많은 양의 혈흉이 있었던 2예에서는 색전치료에도 불구하고 사망하였다.
결론: 늑간동맥 손상을 줄이기 위해서는 부행늑간동맥이 있는 늑간의 상연 보다는 중간부위를 천자하는 것이 바람직하다. 경동맥색전술은 늑간동맥출혈의 치료에 매우 효과적인 방법이다.

참고문헌 (Reference)

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