Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.
Cardiovasc Intervent Radiol. 2013 Feb;36(1):111-7. doi: 10.1007/s00270-012-0404-2. Epub 2012 May 8.
This study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE).
The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE.
The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion.
The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.
本研究旨在评估经皮直接穿刺瘤内栓塞（DPE）联合经动脉栓塞（TAE）治疗青少年鼻咽血管纤维瘤（JNA）的临床应用。
本研究纳入了 22 名患者。在透视引导下确认针尖位于 JNA 内且无周围组织渗漏后，使用 18 号针直接穿刺入肿瘤，注入 20-25%N-丁基氰丙烯酸酯。随后通过 TAE 阻塞肿瘤。
JNA 的供血动脉来自颈内动脉和颈外动脉的分支。DPE 联合 TAE 后，控制性血管造影显示整个肿瘤团块的对比染色消失，远端供血动脉消失。栓塞后 4 天内进行手术切除，所有患者均无需输血。
DPE 联合 TAE 是一种安全、可行、有效的方法。它可以有效地使 JNA 血管化，并减少 JNA 切除时的术中出血。
