颌面部先天性动静脉畸形的PVA栓塞治疗

Embolization in Arteriovenous Malformations of Maxillofacial Region with PVA

目的 评价颌面部先天性动静脉畸形行聚乙烯醇泡沫微粒 (PVA)永久性栓塞的治疗效果。方法 8例颌面部先天性动静脉畸形 (男 3例 ,女 5例 )进行了PVA永久性栓塞治疗。数字减影的颈动脉造影在PHILIPSV30 0 0下完成 ,PVA颗粒 (2 5 0～ 5 0 0 μm) ,栓塞用导管 4F或 3F。 结果 5例患者仅行单次栓塞 ,3例患者行双次栓塞。栓塞后造影 ,异常血管团消失 ,均达到影像治愈 ;搏动、杂音栓塞后消失 ;4例肿胀得到改善。栓塞后 1～ 6月 ,未发现有口腔内渗血或出血。栓塞后反应主要表现为肿胀、疼痛、发热 ,一般持续 3～ 7d。结论 颌面部动静脉畸形的PVA栓塞治疗安全、有效 ,但远期效果还有待长期观察。

Objective To evaluate the embolization of arteriovenous malformations of the maxillofacial region with PVA.Methods 8 cases (male:3, female:5) of arteriovenous malformations of the maxillofacial region comprised this study group. The embolic material used was PVA (Polyvinyl Alcohol Foam) particles (250 500um) injected using 4.0 to 3.0 French size catheters, catheterized selectively in the feeding pedicles of the AVM under the guidance of DSA machine (PHILIPS V3000) Results Five patients were embolized an a single session, and three patients needed two sessions. Immediate angiographical results showed total disappearance of the AVMs in all patients. Swelling, pulsation, and bruit were disappeared after embolization. Pericoronal oozing of blood and acute arterial bleeding was controllable. Local pain, swelling, and low grade fever usually lasted from 3 to 7 days after embolization. Conclusion The embolization of arteriovenous malformations of the maxillofacial region with PVA is effective and safe, and the longer follow up is expected. [