Ethanol Embolization of Nasal Arteriovenous Malformations: A 10-Year, Single-Institution Experience
Ethanol Embolization of Nasal Arteriovenous Malformations: A 10-Year, Single-Institution Experience
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鼻动静脉畸形的乙醇栓塞：10 年单机构经验
DOI：
10.1007/s00270-021-03043-5
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发表时间：
2022-01-12
影响因子：
2.9
通讯作者：
Yang, Xi-tao
中科院分区：
文献类型：
--
作者：
Li, Xin-yu;Su, Li-xin;Yang, Xi-tao
PurposeTo总结一个10年，单一机构的经验，乙醇栓塞的鼻动静脉畸形（NAVMs）在52 patients.Patients和methodsThe目前的工作是一项回顾性研究的52例患者（年龄在1和67岁之间）与NAVMs谁是2009年8月和2019年8月之间的乙醇栓塞治疗。NAVM的诊断基于临床和影像学研究，包括超声、计算机断层扫描血管造影和数字减影血管造影。本研究中使用的栓塞技术包括经动脉、直接穿刺和两者结合。在平均55.2个月的时间内评估了临床和血管造影特征、治疗方法、临床结局和并发症最后一次栓塞后1-119个月的随访结果（52例患者的140例栓塞手术）包括经动脉入路（1例患者），直接穿刺（2例患者），以及经动脉和直接穿刺的组合（49例患者）。病灶大小与治疗次数（r= 0.780，P = 0.0005）和乙醇注射量（r= 0.840，P = 0.0004）呈正相关。本研究的结果显示，治疗结果为2例患者（3.8%）完全缓解，在整个随访期间（范围，1-119个月;平均55.2个月）无复发，50例患者（96.2%）部分缓解。共有7名患者（13.5%）经历了一个或多个并发症，包括皮肤坏死的一名患者（1.9%），短暂性血红蛋白尿的五名患者（9.6%），和皮肤水疱的五名patients（9.6%.ConclusionThe报告的单一机构的经验显然表明，乙醇栓塞治疗有可能成功地断流NAVM，也显着改善症状和体征。此外，很明显，经动脉和直接穿刺技术的组合使用有可能增加NAVM患者的治疗反应率。
PurposeTo summarize a 10-year, single-institution experience with ethanol embolization of nasal arteriovenous malformations (NAVMs) in 52 patients.Patients and methodsThe present work was a retrospective study of 52 patients (aged between 1 and 67 years) with NAVMs who were treated with ethanol embolization between August 2009 and August 2019. The diagnosis of NAVMs was established based on clinical and imaging studies including ultrasound, computer tomography angiography, and digital subtract angiography. Embolization techniques used in the current study included transarterial, direct puncture, and a combination of both. The clinical and angiographic features, treatment methods, clinical outcomes, and complications were assessed within the mean period of 55.2 months (range, 1–119 months) after the last embolization.ResultsThe total number of embolization sessions (140 embolization procedures in 52 pts) included transarterial approach (1 pt), direct puncture (2 pt), and a combination of transarterial and direct puncture (49 pts). There was a positive correlation between nidus size and treatment sessions (r= 0.780,P= 0.0005) and the amount of ethanol injected (r= 0.840,P= 0.0004). Results of the current study showed that the therapeutic outcomes were complete response in two patients (3.8%) without recurrence throughout the follow-up period (range, 1–119 months; mean, 55.2 months), and partial response in 50 patients (96.2%). A total of seven patients (13.5%) experienced one or more complications, including skin necrosis in one patient (1.9%), transient hemoglobinuria in five patients (9.6%), and skin blister in five patients (9.6%).ConclusionThe reported single-institution experience evidently indicated that ethanol embolotherapy has the potential to successfully devascularize NAVMs and also significantly improve symptoms and signs. Further, it was evident that the use of a combination of transarterial and direct puncture techniques has the potential to increase the rate of therapeutic response in patients with NAVMs.