介入栓塞术联合术后注射无水乙醇治疗颌面部动静脉畸形.docVIP

介入栓塞术联合术后注射无水乙醇治疗颌面部动静脉畸形[摘要]目的:探讨以数字减影成像显影下血管介入栓塞技术联合术后注射无水乙醇治疗颌面部动静脉畸形的疗效。方法:对6例颌面部动静脉畸形患者行血管介入造影检查,并超选择性插管栓塞供血动脉及病灶,注入聚乙烯醇颗粒、无水乙醇等栓塞剂栓塞畸形血管团,术后根据恢复情况定期在病灶血管腔内注射无水乙醇。结果:6例颌面部动静脉畸形患者均栓塞成功,达到临床治疗目的,无严重并发症发生。结论:血管介入造影下超选择性插管栓塞联合术后无水乙醇是治疗颌面部动静脉畸形的一种有效、安全的方法。 [关键词]颌面部;动静脉畸形;数字减影;超选择性栓塞 [中图分类号]R782 [文献标识码]A [文章编号]1008-6455(2010)06-0847-03 Treatment of oral and maxillofacial arteriovenous malformations bypercutaneous ethanol injection after selectivly arterial embolization LI Jin,CHEN Ju-feng,XIAN Dan,LI Jia-ping,LAO Jun-ping,MO Chu-jia,LI Jie (Department of Oral Maxillofacial Surgery,The First People’s Hospital of Foshan,Foshan 528000,Guangdong, China) Abstract:ObjectiveTo evaluate the curative effect of the treatment of oral and maxillofacial arteriovenous malformations by percutaneous ethanol injection after superselective angiography with digital subtraction and embolization. Methods 6 cases of oral and maxillofacial arteriovenous malformations, confirmed by angiography of the left and right external carotid artery,were applied selective arterial embolization with polyvinyl alcohol, ethanol,et al. All cases were injected appropriate ethanol accroding the changes of the nidus after the treatment of arterial embolization. Results All cases were super-selectivlyembolied sucessfully,The bodies of tumors became obviously small and hard.There were no severe complications in all the cases. Conclusion Superselective angiography with digital subtraction and embolization combined with percutaneous ethanol injection may be a safer and more effective method in the treatment oforal and maxillofacial arteriovenous malformations. Key words:oral and maxillofacial;arteriovenous malformations;digital subtraction angiography;selectivly arterial embolization 动静脉畸形(arteriovenous malformations,AVM)多为先天性发育异常,动、静脉之间存在不同程度的直接交通,动脉血经异常血管团迅速流入增粗扭曲的静脉。该病以往又称为“蔓状血管瘤”。AVM病变广泛、血供丰富,因易出现术中大出血,故单纯手术难以切除,且术后易复发[1-2]。近年来,介入放射学的发展为颌面部AVM的治疗开辟了新途径。我院应用血管内介入栓塞术结合术后无水乙醇注射治疗颌面部AVM取得