50%乙醇栓塞治疗儿童YakesⅣ型动静脉畸形

Embolization therapy using 50% concentration ethanol for Yakes type Ⅳ arteriovenous malformations in child patients

目的 探讨50%乙醇经微导管栓塞治疗儿童YakesⅣ型动静脉畸形(AVM)的安全性和有效性。方法 回顾性分析7例YakesⅣ型AVM患儿的临床资料,局部直接穿刺病变失败后,采用微导管超选病变供血动脉推注50%乙醇,观察疗效、不良反应和并发症。结果 7例患儿均成功实施超选择性AVM栓塞术,共进行了24次栓塞。2例出现皮肤水疱,5例出现局部肿胀,未出现皮肤坏死、神经损伤等严重并发症。术后随访6~12个月,病变消退率为50%~80%,7例治疗效果达到好转。结论 50%乙醇经微导管栓塞治疗儿童YakesⅣ型AVM安全有效,为局部直接穿刺失败的患者提供了补救治疗方式。

Objective To investigate the safety and efficacy of transcatheter embolization using 50%concentration ethanol in the treatment of Yakes type IV arteriovenous malformations(AVM) in child patients.Methods The clinical data of 7 child patients with Yakes type IV AVM were retrospectively analyzed.In the7 child patients the local direct puncture of AVM failed.After superselective catheterization of the lesion-feeding artery with a microcatheter was accomplished,50% concentration ethanol was injected to make embolization of the AVM.The clinical effect,adverse reactions and complications were recorded.Results Successful superselective embolization for AVM was accomplished in all the 7 child patients,and a total of 24 times of embolization procedure were carried out.Skin blisters occurred in 2 child patients,and 5 child patients developed local soft tissue swelling.No serious complications such as skin necrosis,nerve injury,etc.occurred.All the child patients were followed up for 6-12 months.The regression rate of lesion was 50%-80%,and the improvement of lesion was achieved in all the 7 child patients.Conclusion For the treatment of Yakes type IV AVM in child patients,transcatheter embolization using 50% concentration ethanol is clinically safe and effective.This technique provides a remedial treatment for the child patients,in whom the local direct puncture of AVM fails.