Paes E H, Vollmar J F
Klinikum der Universität, Abteilung für Gefäss-, Thorax-, und Herzchirurgie, Ulm, B.R.D.
Ned Tijdschr Geneeskd. 1990 Feb 3;134(5):235-9.
A complete check-up of vascular morphology and haemodynamics in patients resulted in a differentiation of three clinical entities: (I) type F. P. Weber: multiple active arteriovenous fistulas inducing overgrowth of the skeleton, (2) type Klippel-Trenaunay: venous angiodysplasia with the triad localized gigantism, varicose veins, naevus flammeus, (3) type Servelle-Martorell: systemic haemangiomatosis including the bone and soft tissues resulting in hypoplasia of the skeleton. Early diagnosis and differentiation of these different clinical types are needed for the assessment of the spontaneous course of the disease and choice of an optimal therapeutical approach. In the presence of active arteriovenous fistula (type F. P. Weber) the therapeutic principle should be focused on the normalisation of the shunt volume by surgery (skeletonisation) or catheter embolisation. In patients with venous angiodysplasias (type Klippel-Trenaunay or Servelle-Martorell) the therapy is aimed at prevention or reduction of deep venous insufficiency and is basically conservative by external compression bandages.
对患者的血管形态和血流动力学进行全面检查后,区分出三种临床类型:(1)F.P.韦伯型:多发性动静脉瘘导致骨骼过度生长;(2)克-特综合征型:静脉血管发育异常,伴有三联征,即局限性巨大症、静脉曲张、火焰状痣;(3)塞尔韦-马托雷尔型:全身性血管瘤病,累及骨骼和软组织,导致骨骼发育不全。为了评估疾病的自然病程并选择最佳治疗方法,需要早期诊断并区分这些不同的临床类型。对于存在活动性动静脉瘘(F.P.韦伯型)的患者,治疗原则应侧重于通过手术(骨骼化)或导管栓塞使分流体积恢复正常。对于患有静脉血管发育异常(克-特综合征型或塞尔韦-马托雷尔型)的患者,治疗旨在预防或减轻深静脉功能不全,基本上采用外部压迫绷带进行保守治疗。