Chewning Rush H, Monroe Eric J, Lindberg Antoinette, Koo Kevin S H, Ghodke Basavaraj V, Gow Kenneth W, Javid Patrick J, Jinguji Thomas M, Perkins Jonathan A, Shivaram Giridhar M
1Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital and University of Washington School of Medicine, Seattle, Washington USA.
2Department of Orthopedics and Sports Medicine, Seattle Children's Hospital and University of Washington School of Medicine, Seattle, Washington USA.
CVIR Endovasc. 2018;1(1):22. doi: 10.1186/s42155-018-0028-y. Epub 2018 Oct 25.
The purpose of this study was to evaluate safety, technical success, and clinical outcomes of treatment for venous malformations using -BCA glue embolization immediately prior to excision. Sixty three patients (22 male, 41 female; mean age 12 years (range 1-25)) who underwent 70 procedures for extremity and trunk venous malformations were reviewed. Indications for treatment included pain (100%), swelling (22%), and diminished range of motion (16%). Thirty seven patients (59%) had undergone prior stand-alone interventional or surgical treatment but were persistently symptomatic. Safety, technical and clinical success were retrospectively assessed.
Embolization was technically successful in 100% of patients. Mean lesion size was 3.0 × 2.9 × 5.7 cm. Three patients (5%) underwent planned, second stage procedures for lesions intentionally not treated at the first procedure. Four patients (6%) underwent an unplanned, second stage procedure for residual disease after the primary operation. Mean and median follow-up duration were 18 and 17 months, respectively (range 3 to 35 months). Symptomatic improvement was achieved in 58 patients (92%), of whom 41 (65%) reported complete elimination of pain. There were no recognized instances of nontarget embolization or other complications of the interventional procedure. One patient required additional surgery for wound dehiscence and one patient developed an abscess requiring incision and drainage. Minor surgical complications included surgical site skin infections ( = 5) and numbness ( = 1). Mean and median surgical blood loss volumes were 131 mL and 10 mL, respectively. One patient required perioperative blood transfusion.
Extremity and truncal venous malformations can be safely and effectively treated in a single-stage fashion using glue embolization immediately preceding excision.
本研究旨在评估在切除术前立即使用 -BCA 胶水栓塞治疗静脉畸形的安全性、技术成功率和临床疗效。回顾了 63 例（22 例男性，41 例女性；平均年龄 12 岁（范围 1 - 25 岁））接受 70 次肢体和躯干静脉畸形治疗手术的患者。治疗指征包括疼痛（100%）、肿胀（22%）和活动范围减小（16%）。37 例患者（59%）曾接受过单独的介入或手术治疗，但症状持续存在。对安全性、技术和临床成功率进行了回顾性评估。
栓塞在 100%的患者中技术成功。平均病变大小为 3.0×2.9×5.7 厘米。3 例患者（5%）因首次手术故意未治疗的病变接受了计划性二期手术。4 例患者（6%）因初次手术后残留疾病接受了非计划性二期手术。平均和中位随访时间分别为 18 个月和 17 个月（范围 3 至 35 个月）。58 例患者（92%）症状改善，其中 41 例（65%）报告疼痛完全消除。未发现非靶栓塞或介入手术其他并发症的公认病例。1 例患者因伤口裂开需要额外手术，1 例患者发生脓肿需要切开引流。轻微手术并发症包括手术部位皮肤感染（=5）和麻木（=1）。平均和中位手术失血量分别为 131 毫升和 10 毫升。1 例患者需要围手术期输血。
肢体和躯干静脉畸形可在切除术前立即使用胶水栓塞以单阶段方式安全有效地治疗。
