ROADMAP功能在DSA引导下静脉畸形血管内硬化治疗的应用研究

Application of ROADMAP function in endovascular sclerotherapy of venous malformations guided by digital subtraction angiography

目的探究ROADMAP功能在数字减影血管造影(digital substraction angiography,DSA)引导下静脉畸形(venous malformation,VM)血管内硬化治疗的应用。方法自2019年5月至2020年7月,上海交通大学医学院附属第九人民医院整复外科对11例患者在DSA引导下行VM血管内硬化治疗,术中使用ROADMAP(路图)功能实时监测硬化剂给药。术后进行随访和疗效评价。结果11例患者(13处病灶)共接受25次介入硬化治疗,平均(2.1±0.9)次。平均治疗时间为(18.5±3.4)min,其中ROADMAP功能平均使用时间为(52.5±10.3)s。所有患者均随访24个月,7例治愈,2例明显缓解,2例部分缓解,均无复发或进展。所有患者术后均未出现出血、破溃、感染及功能障碍等严重并发症。结论ROADMAP功能可提高VM治疗安全性、把握病灶结构、使药物剂量更精确,并且未明显增加手术时长,值得临床推广应用。

Objective To explore the application of ROADMAP function in endovascular sclerotherapy of venous malformations guided by digital subtraction angiography(DSA).Methods From May 2019 to July 2020,11 patients underwent endovascular sclerotherapy of venous malformations guided by DSA.The ROADMAP function was used to monitor the administration of sclerosant in real time during the operation.Postoperative follow-up and efficacy evaluation were performed.Results Eleven patients received sclerotherapy of25 times for 13 lesions,with an average of(2.1±0.9)times.The average treatment period was(18.5±3.4)min,and the average use period of the ROADMAP function was(52.5±10.3)s.All patients were followed up for 24 months.Seven cases had complete response,2 cases had significant response and 2 cases had partial response.No recurrence or progression was found.No serious complications such as bleeding,ulceration,infection or dysfunction occurred in all patients.Conclusion The ROADMAP function can improve the safety of treatment,grasp the structure of lesion,make the drug dose more accurate and does not significantly increase the operative duration.It should be considerable for clinical application.