广泛性动静脉畸形介入治疗的临床应用

Clinical Application of Interventional Management in Diffuse Arteriovenous Malformation

广泛性动静脉畸形（ＡＶＭ）伴多发动静脉瘘（ＡＶＦ）的治疗文献报道甚少，３例此类患者我们采用经导管介入栓塞＋外科手术的方法：即采取先丝微粒后丝线段、先小后大和分段分期的介入栓塞，以达先栓小的病理血管，防止或减少侧支供血的建立，尔后以线段栓塞较大的病理血管。因ＡＶＭ的侧支供血甚多，丝微粒或丝线段有可能通过瘘口使ＡＶＦ再通，又施以栓后和／或栓塞同时＋手术，切除大的ＡＶＭ团块和切断、结扎ＡＶＦ交通，取得了临床比较满意的结果。

Treatment of diffuse arteriovenous malformation(AVM)accompanied with multiple arteriovenous fistula(AVF) was rarely reported in the literature.Interventional embolization through catheter plus surgical operation were performed in three patients for AVM accompanied with multiple AVvF. Briefly the patients underwent vascular intervention initiately with silk particulates and then with silk threads,tbe small sized pathologic vessels were embolized with silk particulates to prevent or decrease the establishment of collateral blood supply. then embolized the large sized pathologic vesseles with silk threads. As the collateral blood supply or AVM is very rich,the silk particulates or silk threads may cross the opening of the fistula and make the AVF recommunicated. Postembolization and/or just embolization plus surgical operation were employed to dissect the large AVM mass,cut and ligate the communicating branchs of AVF. The clinical effects is satisfactory.