Abruzzo Todd A, Heran Manraj K S
Department of Neurosurgery, University of Cincinnati Neuroscience Institute, University of Cincinnati Colleges of Medicine and Engineering and Mayfield Clinic, Cincinnati, Ohio, USA.
Tech Vasc Interv Radiol. 2011 Mar;14(1):50-6. doi: 10.1053/j.tvir.2010.07.008.
Transarterial embolization of head and neck tumors can be done for a variety of indications, including tumoral epistaxis and high-output cardiac failure, but is mainly done before surgical resection. This technique offers higher surgical cure rates and faster recovery, while decreasing surgical morbidity by curtailing blood loss and reducing the duration of surgery. Patients with epistaxis are considered for endovascular management when they have failed conservative management, including topical vasoconstrictors, cautery, and nasal packing (anterior and posterior). Sudden arterial bleeding in patients undergoing transsphenoidal or maxillofacial surgery is also considered an indication for endovascular management. If performed with the appropriate attention, endovascular management of epistaxis is highly effective with a low risk of complications.
头颈部肿瘤的经动脉栓塞可用于多种适应症,包括肿瘤性鼻出血和高输出量心力衰竭,但主要在手术切除前进行。该技术可提高手术治愈率并加快恢复,同时通过减少失血和缩短手术时间降低手术并发症发生率。鼻出血患者在保守治疗(包括局部血管收缩剂、烧灼和鼻腔填塞(前后鼻孔填塞))失败后,可考虑进行血管内治疗。经蝶窦或颌面外科手术患者的突发性动脉出血也被视为血管内治疗的适应症。如果操作得当,鼻出血的血管内治疗效果显著且并发症风险低。