PDF(Pubmed)
Abstract：
UNASSIGNED: To retrospectively report our preliminary experience of treating hand arteriovenous malformations (AVMs) with embolo/sclerotherapy.
UNASSIGNED: Retrospectively review the demographics, treatment detail, outcome data, and complications of 13 consecutive patients with hand AVMs from January 2018 to December 2021. We embolize the dominant outflow vein with elastic coils and then use absolute ethanol or polidocanol for intravascular sclerotherapy and bleomycin for interstitial sclerotherapy.
UNASSIGNED: Yakes type II presents in four lesions, type IIIa in six, and type IIIb in three. A total of 29 treatment episodes were conducted for the 13 patients (1 episode for 3 patients, 2 for 4 patients, and 3 for 6 patients; the repeated treatment rate was 76.9%). The mean stretched length of coils for 1 treatment episode was 95 cm. The mean absolute ethanol dosage was 6.8 ml (range 4-30 ml). In addition, 10 ml of 3% polidocanol foam was injected and interstitial sclerotherapy with 150,000 IU bleomycin was performed on every patient. The post-operative arterial-dominant outflow vein pressure index (AVI) increased in the 29 procedures (6.55 ± 1.68 vs. 9.38 ± 2.80, P < 0.05). The Mann-Whitney U test showed that the post-operative AVI was higher in patients without re-intervention (P < 0.05). Local swelling occurred after all the procedures. Blistering occurred in 6 of the patients in 13 (44.8%) of the 29 procedures. Superficial skin necrosis occurred in 3 of the patients in 5 (17.2%) of the 29 procedures. The swelling, blistering, and superficial skin necrosis recovered within 4 weeks. No finger amputation occurred. The follow-up time was 6 months. The 6-month assessment of clinical improvement after the last treatment episode showed that 2 patients were cured, 10 were improved, and 1 remained unchanged. With regard to angiographic evaluation, 9 showed partial response and 4 complete response.
UNASSIGNED: Embolo/sclerotherapy can be effective and safe for hand AVM. The AVI increased significantly after embolo/sclerotherapy, and the index may be valuable in predicting recurrence in further study.
UNASSIGNED: Retrospectively review the demographics, treatment detail, outcome data, and complications of 13 consecutive patients with hand AVMs from January 2018 to December 2021. We embolize the dominant outflow vein with elastic coils and then use absolute ethanol or polidocanol for intravascular sclerotherapy and bleomycin for interstitial sclerotherapy.
UNASSIGNED: Yakes type II presents in four lesions, type IIIa in six, and type IIIb in three. A total of 29 treatment episodes were conducted for the 13 patients (1 episode for 3 patients, 2 for 4 patients, and 3 for 6 patients; the repeated treatment rate was 76.9%). The mean stretched length of coils for 1 treatment episode was 95 cm. The mean absolute ethanol dosage was 6.8 ml (range 4-30 ml). In addition, 10 ml of 3% polidocanol foam was injected and interstitial sclerotherapy with 150,000 IU bleomycin was performed on every patient. The post-operative arterial-dominant outflow vein pressure index (AVI) increased in the 29 procedures (6.55 ± 1.68 vs. 9.38 ± 2.80, P < 0.05). The Mann-Whitney U test showed that the post-operative AVI was higher in patients without re-intervention (P < 0.05). Local swelling occurred after all the procedures. Blistering occurred in 6 of the patients in 13 (44.8%) of the 29 procedures. Superficial skin necrosis occurred in 3 of the patients in 5 (17.2%) of the 29 procedures. The swelling, blistering, and superficial skin necrosis recovered within 4 weeks. No finger amputation occurred. The follow-up time was 6 months. The 6-month assessment of clinical improvement after the last treatment episode showed that 2 patients were cured, 10 were improved, and 1 remained unchanged. With regard to angiographic evaluation, 9 showed partial response and 4 complete response.
UNASSIGNED: Embolo/sclerotherapy can be effective and safe for hand AVM. The AVI increased significantly after embolo/sclerotherapy, and the index may be valuable in predicting recurrence in further study.
摘要：
■回顾性报告我们用栓塞/硬化疗法治疗手动静脉畸形（AVM）的初步经验。
■回顾人口统计学，治疗细节,结果数据，2018年1月至2021年12月连续13例手部AVM患者的并发症。我们用弹性线圈栓塞优势流出静脉，然后使用无水乙醇或polidocanol进行血管内硬化治疗，使用博来霉素进行间质硬化治疗。
■YakesII型表现在四个病变中，IIIa型六分之一，和IIIb型三。共对13例患者进行了29次治疗(3例患者1次发作,2对4名患者，6例患者为3例；重复治疗率为76.9%）。1次治疗的线圈的平均拉伸长度为95厘米。平均无水乙醇剂量为6.8ml（范围为4-30ml）。此外,注射10ml3％的polidocanol泡沫，并对每位患者进行150,000IU博来霉素的间质硬化治疗。29例手术中术后动脉主导流出静脉压指数（AVI）升高（6.55±1.68vs.9.38±2.80,P<0.05)。Mann-WhitneyU检验显示,未再次干预的患者术后AVI较高(P<0.05)。所有手术后都发生局部肿胀。在29例手术中的13例（44.8％）中，有6例患者发生了起泡。在29例手术中的5例（17.2％）中，有3例患者发生了浅表皮肤坏死。肿胀，起泡，浅表皮肤坏死在4周内恢复。没有发生手指截肢。随访时间为6个月。最后一次治疗后6个月的临床改善评估显示，2例患者治愈，10改进了1保持不变。关于血管造影评估，9显示部分响应和4完全响应。
■Embolo/硬化疗法对手部AVM有效且安全。栓塞/硬化治疗后AVI显著增加，该指标对进一步研究中预测复发可能有价值。
■回顾人口统计学，治疗细节,结果数据，2018年1月至2021年12月连续13例手部AVM患者的并发症。我们用弹性线圈栓塞优势流出静脉，然后使用无水乙醇或polidocanol进行血管内硬化治疗，使用博来霉素进行间质硬化治疗。
■YakesII型表现在四个病变中，IIIa型六分之一，和IIIb型三。共对13例患者进行了29次治疗(3例患者1次发作,2对4名患者，6例患者为3例；重复治疗率为76.9%）。1次治疗的线圈的平均拉伸长度为95厘米。平均无水乙醇剂量为6.8ml（范围为4-30ml）。此外,注射10ml3％的polidocanol泡沫，并对每位患者进行150,000IU博来霉素的间质硬化治疗。29例手术中术后动脉主导流出静脉压指数（AVI）升高（6.55±1.68vs.9.38±2.80,P<0.05)。Mann-WhitneyU检验显示,未再次干预的患者术后AVI较高(P<0.05)。所有手术后都发生局部肿胀。在29例手术中的13例（44.8％）中，有6例患者发生了起泡。在29例手术中的5例（17.2％）中，有3例患者发生了浅表皮肤坏死。肿胀，起泡，浅表皮肤坏死在4周内恢复。没有发生手指截肢。随访时间为6个月。最后一次治疗后6个月的临床改善评估显示，2例患者治愈，10改进了1保持不变。关于血管造影评估，9显示部分响应和4完全响应。
■Embolo/硬化疗法对手部AVM有效且安全。栓塞/硬化治疗后AVI显著增加，该指标对进一步研究中预测复发可能有价值。
