经皮穿刺DSA引导下无水乙醇硬化治疗头颈部静脉畸形

Sclerotherapy of venous malformation in the head and neck region with absolute ethanol under the guide of DSA

目的:探讨DSA引导下无水乙醇硬化治疗头颈部静脉畸形的效果。方法:对2006年3月-2008年4月间应用DSA引导下无水乙醇硬化治疗的53例头颈部静脉畸形患者进行回顾分析,采用影像学及问卷调查的方法评价治疗效果,并对治疗并发症进行分析。结果:所有患者均对治疗效果满意。术后MRI显示,12例病变完全消退,32例消退率≥50%,7例消退率25%～50%,2例消退率<25%。并发症包括暂时性面神经麻痹、皮肤黏膜溃疡,除1例发生永久性面瘫外,其余并发症经处理均消失。无肺动脉痉挛及肺动脉栓塞严重并发症。结论:DSA引导下无水乙醇硬化治疗头颈部静脉畸形是一种安全有效的方法。

PURPOSE： To evaluate the results of endovascular sclerotherapy of venous malformations in the head and neck region using absolute alcohol under the guide of DSA. METHODS： Retrospective study was used in this study. 53 patients with venous malformation in the head and neck were indicated for ethanol sclerotherapy under DSA form March 2006 to April 2008. Follow-up assessment （minimum, 3months; average, 14 months） was made as early results after completion of therapy. Complications were also reported and analyzed. RESULTS： All patients were satisfied with the results. MRI findings improved. Complications ,such as neuropathy, necrosis of skin and mueosa developed during the procedure, all of which were successfully managed with full recovery during follow-up except one with permanent facial nerve palsy. Complications such as acute pulmonary hypertension, cardiovascular collapse and pulmonary embolus were not encountered. CONCLUSIONS： Sclerotherapy with absolute ethanol under the guide of DSA is an important modality of therapy for venous malformation, providing reasonable safety and good therapeutic results.