Department of Radiology, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan.
Cardiovasc Intervent Radiol. 2010 Feb;33(1):191-5. doi: 10.1007/s00270-009-9643-2. Epub 2009 Jul 23.
A 28-year-old woman was referred to our institution with hope for another child after having an abortion several months previously to avoid a potential risk of catastrophic hemorrhage from a retroperitoneal arteriovenous fistula (AVF) with enlarged and twisted draining veins in the pelvis. Multiple branches coming from the right lumbar arteries and the right iliac arteries fed fistulae converging on an enlarged venous pouch anterior to the psoas major muscle in the right retroperitoneal space. It seemed impossible to achieve complete occlusion of the lesion in a single session by either transarterial or transvenous approach. A laparotomy and direct puncture of the enlarged draining vein immediately downstream of the venous pouch was performed and embolization was done with n-butyl cyanoacrylate and the aid of coils. Complete occlusion of the retroperitoneal AVF was achieved and confirmed in control angiography 5 months later.
一位 28 岁的女性，因担心可能会因腹膜后动静脉瘘引起灾难性大出血而在前几个月进行了流产，随后转诊至我院，希望能再次怀孕。在盆腔内，迂曲增粗的引流静脉汇入一个扩大的静脉囊，形成动静脉瘘。瘘由发自右侧腰动脉和髂动脉的多个分支供血。瘘口位于右侧腹膜后腰大肌前方的静脉囊中，似乎不可能通过经动脉或经静脉途径在单次介入治疗中完全闭塞病变。因此，我们进行了剖腹手术，并直接穿刺静脉囊下游的增粗引流静脉，用氰基丙烯酸正丁酯和线圈进行栓塞。5 个月后行控制性血管造影，显示腹膜后动静脉瘘完全闭塞。
