目的:本研究总结了我们在下肢以优势流出静脉(DOV)定位动静脉畸形(AVM)的病灶,并用乙醇和线圈根除病灶的经验。
方法:本研究纳入2017年1月至2018年5月期间行乙醇栓塞联合DOV闭塞的12例下肢AVM患者。选择性血管造影用于定位AVM的病灶,通过直接穿刺途径使用乙醇和线圈根除。所有接受治疗的患者均接受术后随访(范围,14-37个月;平均,25.5个月)。
结果:所有12例患者均接受了29例手术(范围,1-4;意思是,2.4)有27个可拆卸线圈和169个Nester线圈。7例患者(7/12,58.3%)显示完全缓解,5例患者(5/12,41.7%)显示部分缓解。3例患者(3/12,25%)在随访期间出现了小并发症,例如水疱和浅表皮肤溃疡。然而,他们自发地完全恢复了。无重大并发症记录。
结论:乙醇栓塞联合线圈辅助DOV闭塞有可能根除下肢AVM的病灶,并发症发生率可接受。
In the present study, we summarize our experience in locating the nidus of arteriovenous malformations (AVMs) with a dominant outflow vein (DOV) in the lower extremities and eradicating the nidus with ethanol and coils.
Twelve patients with lower extremity AVMs who underwent ethanol embolization combined with DOV occlusion from January 2017 to May 2018 were enrolled in the present study. Selective angiography was used to locate the nidus of the AVMs, which was eradicated using ethanol and coils via the direct puncture pathway. All treated patients underwent postoperative follow-up (mean, 25.5 months; range, 14-37 months).
The 12 patients underwent a total of 29 procedures (mean, 2.4; range, 1-4) with 27 detachable coils and 169 Nester coils (Cook Medical Inc, Bloomington, IN). Of the 12 patients, 7 (58.3%) had a complete response and 5 (41.7%) a partial response. Three patients (25%) had minor complications such as blister and superficial skin ulcers during follow-up. However, they recovered spontaneously and completely. No major complications were recorded.
Ethanol embolization combined with coil-assisted DOV occlusion has the potential to eradicate the nidus of lower extremity AVMs with acceptable complication rates.