Klippel-Trenaunay-Weber综合征的介入治疗

Endovascular intervention for the treatment of Klippel-Trenaunay-Weber syndrome

目的探讨Klippel-Trenaunay-Weber综合征(KTWS)血管内介入治疗的可行性。方法对14例KTWS患者行患肢动脉造影,分别以平阳霉素+超液化碘油、聚乙烯醇颗粒(PVA)、氰丙烯酸盐黏合剂(NBCA)、钢圈进行血管内介入治疗。结果术后所有患者患肢血管瘤(痣)病变和浅静脉曲张明显改善或消失。术后并发症主要为栓塞区域疼痛(9例)、水肿(14例),3例患者出现整条患肢水肿,10例在术后7-9 d自然消退。术后随访1个月,栓塞区域血管瘤(痣)病变有进一步改善,患肢大腿中部周径和膝下10 cm周径分别缩小(2．1±0.3)cm和(2．0±0．2)cm,3例患肢淋巴水肿和3例股浅静脉返流均有所改善。结论采用血管内介入治疗KTWS效果是显著的。

Objective To explore the feasibility of endovascular intervention for the treatment of Klippel-Trenaunay-Weber syndrome （ KTWS ）. Methods Fourteen KTWS patients underwent arteriography followed by endovascular intervention with bleomycin（ A5 ） ＋ extraliquid lipiodol, PVA, NBCA, steel coil, respectively. Results Both haemangioma （nevus） lesion and varicosities of the superficial vein in the involved limb improved in all 14 patients significantly. Main complications were pain, swelling of the embolized area. Severe swelling of the whole limb occurred in 3 eases, which subsided spontaneously within 7 - 9 days. At one month follow-up limb girth at the middle part of the thigh and at the point of 10 cm below the knee reduced by 2. 1 ± 0. 3 cm and 2.0 ± 0. 2 cm respectively. Preoperative lymphatic edema of the limb in 3 cases （3/4） and the regurgitation of the superficial femoral vein in 3 cases also improved significantly. Conclusion Endovascular intervention of KTWS leads to symptomatic improvement of patients with KTWS.