Absolute Ethanol Embolization of Lip Arteriovenous Malformations: Observational Results from 10 Years of Experience
Absolute Ethanol Embolization of Lip Arteriovenous Malformations: Observational Results from 10 Years of Experience
复制标题
唇动静脉畸形的绝对乙醇栓塞：10年经验观察结果
DOI：
10.1016/j.jvir.2021.09.004
复制
发表时间：
2021-12-31
影响因子：
2.9
通讯作者：
Yang, Xi-Tao
中科院分区：
文献类型：
--
作者：
Su, Li-Xin;Li, Xin-Yu;Yang, Xi-Tao
目的：目的：评价无水乙醇栓塞治疗唇部动静脉畸形（AVM）的安全性和有效性。21例患者（35例手术，20.2%）仅采用直接穿刺治疗唇AVM，13例患者（18例手术，10.4%）仅采用经动脉栓塞治疗唇AVM，60例患者（120例手术，69.3%）采用两种方法联合治疗唇AVM。根据患者的要求，包括患者偏好、功能损害和皮肤坏死，在栓塞后进行辅助手术切除，以达到美容目的。平均随访时间为30.9个月± 27.6个月。随访包括临床访问和电话问卷调查，以评估的临床体征和症状的AVM以及生活质量measures.Results：76例患者中，51例显示100%的AVM血管断流，确定使用动脉造影，其次是23 76%-99%断流和2 50%-75%断流。在76名患者中，40名患者在栓塞后症状完全缓解，25名患者在美容畸形方面获得重大改善。此外，54例患者单独使用乙醇栓塞治疗获得了令人满意的功能和美观改善，而22例患者使用乙醇栓塞治疗和手术干预联合治疗获得了相似的结局。三十三个不良事件（包括1个主要）记录。结论：酒精栓塞唇AVM，作为中流砥柱，是有效的管理这些病变，可接受的并发症。栓塞后手术切除可改善部分患者的功能和美观。
Purpose: To evaluate the safety and efficacy of ethanol embolization of lip arteriovenous malformations (AVMs).Materials and Methods: Seventy-six patients with lip AVMs were treated with 173 ethanol embolization procedures. Lip AVMs were treated with direct puncture alone in 21 patients (35 procedures, 20.2%), transarterial embolization alone in 13 patients (18 procedures, 10.4 %), and a combination of both in 60 patients (120 procedures, 69.3%). Adjunctive surgical resection was performed after embolization for cosmetic purposes based on the patient's request, including patient preference, functional impairment, and skin necrosis. The mean duration of follow-up was 30.9 months +/- 27.6. The follow-up included clinic visits and telephonic questionnaires to evaluate the clinical signs and symptoms of AVMs as well as quality of life measures.Results: Of 76 patients, 51 showed 100% devascularization of AVMs, as determined using arteriography, followed by 23 with 76%-99% devascularization and 2 with 50%-75% devascularization. Of the 76 patients, 40 achieved complete symptom relief and 25 achieved major improvements in cosmetic deformity after embolization. Additionally, 54 patients achieved satisfactory function and aesthetic improvement with ethanol embolotherapy alone, whereas 22 achieved similar outcomes with a combination of ethanol embolotherapy and surgical intervention. Thirty-three adverse events (including 1 major) were documented.Conclusions: Ethanol embolization of lip AVMs, as a mainstay, is efficacious in managing these lesions, with acceptable complications. Surgical resection after embolization may improve function and cosmesis in a subset of patients.