Jackson I T, Jack C R, Aycock B, Dubin B, Irons G B
Section of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minn.
Plast Reconstr Surg. 1989 Jul;84(1):47-54. doi: 10.1097/00006534-198907000-00010.
It is necessary that the treatment of arteriovenous malformations in general be undertaken by a team that consists of a radiologist who is experienced in angiography and embolization and a plastic surgeon. The latter should be well versed in angiographic techniques and should be able to comprehend the dynamics of these malformations. In this report, three patients with high-flow, high-shunt arteriovenous intraosseous malformations of the head are presented. Two of these presented as emergencies with almost uncontrollable bleeding and were initially treated with embolization and then mandibular resection and reconstruction within the first 48 hours. In one patient, a further reconstructive procedure using free vascularized tissue was carried out. A third patient with involvement of the maxilla, again presenting with bleeding, was treated with embolization and, because of the deformity that would be created by resection, was simply observed. However, this patient is to be reassessed in the future and may well come to maxillectomy. It is emphasized that the treatment of these patients requires careful assessment, embolization, and resection as indicated after discussion between radiologist and surgeon.
一般而言，动静脉畸形的治疗有必要由一个团队来进行，该团队应由一位在血管造影和栓塞方面经验丰富的放射科医生和一位整形外科医生组成。后者应精通血管造影技术，并且能够理解这些畸形的动态变化。在本报告中，介绍了三名患有头部高流量、高分流性骨内动静脉畸形的患者。其中两名患者以紧急情况就诊，伴有几乎无法控制的出血，最初接受了栓塞治疗，然后在48小时内进行了下颌骨切除和重建。在一名患者中，还进行了一次使用游离带血管组织的进一步重建手术。第三名累及上颌骨的患者同样出现出血症状，接受了栓塞治疗，由于切除会造成畸形，所以仅进行了观察。然而，该患者未来需要重新评估，很可能会接受上颌骨切除术。需要强调的是，这些患者的治疗需要经过放射科医生和外科医生讨论后进行仔细评估、栓塞和切除。
