颌骨中心性动静脉畸形的栓塞与手术治疗

Assessment of efficacy of endovascular embolization for central arteriovenous malformations (AVM) in the jaw

目的 研究颌骨中心性动静脉畸形血管造影特征及栓塞治疗的效果。方法 对 1 1例颌骨中心性动静脉畸形行血管造影及栓塞治疗 ,其中 9例栓塞后行颌骨刮治。所有病例均定期随访 ,分析其造影特征 ,并评价其治疗效果。结果 1 1例中 9例造影显示颌骨中心大范围静脉腔。 9例栓塞后手术中出血明显减少 ,且保持了颌骨的连续性 ;9例中 5例随访 1 8～ 2 7个月无复发。 2例单纯栓塞治疗病例 ,栓塞后追踪 2 4个月无复发。结论 颌骨中心性动静脉畸形栓塞后手术治疗 ,术中出血明显减少 ,并可使颌骨的连续性得以保存 ;部分病例经动脉和瘤腔栓塞可以根治。

Objective To study the angiographic properties of central AVMs in the jaw, and to investigate the efficacy of embolization of them. Methods Eleven cases of central AVMs underwent angiography and embolization, nine cases experienced surgery after embolization, and the other two cases were embolized alone; all these cases were followed up after treatment. The angiographic features and embolization results were analyzed. Results Large venous pouches were angiographically opacified in 9 of 11 AVMs. Of the nine operated cases, curettage was safely performed. The intraoperative bleeding was evidently decreased, and the continuity of the jaw was preserved. Five of these operated cases were free of recurrence during 18～27 months in follow up. The two cases embolized alone were free of recurrence during 24 months' follow up. Conclusions Via arterial and venous approaches, embolization could greatly decrease the intraoperative bleeding and thus help to preserve the continuity and potentiality of development of the jaw for intraosseous AVMs, moreover, it may be curative in some cases.