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臀部动静脉畸形的外科治疗

Surgical treatment of arteriovenous malformations of the buttock.

作者信息

Laurian Claude, Paraskevas Nikos, Bigorre Michele, Masonni Claudine, Cerceau Pierre, Toni Francesca, Bisdorff Annouck

机构信息

Department of Vascular Surgery, Saint Joseph Hospital, Paris, France.

Department of Vascular Surgery, Bichat Hospital, Paris, France.

出版信息

J Vasc Surg Cases Innov Tech. 2022 Jul 1;8(4):703-707. doi: 10.1016/j.jvscit.2022.05.008. eCollection 2022 Dec.

Abstract

For symptomatic buttock arteriovenous malformations (AVMs), embolization techniques and surgical resection have been suggested as treatment options. Our aim was to evaluate the feasibility and long-term results after a single surgical resection. Twelve patients had undergone surgical resection without preoperative embolization. Of the 12 patients, 11 had had incomplete procedures, 9 of whom had undergone arterial embolization 1 to 3 years previously. All the patients were symptomatic. Computed tomography scans showed AVMs located in the cellular spaces with preservation of the gluteal muscle. The median follow-up time was 80 months. On the last follow-up computed tomography scan, 67% had had no residual AVM. The use of preoperative embolization, especially with nonresorbable embolic material (Onyx; Medtronic, Dublin, Ireland), makes AVM resection and imaging follow-up more difficult because of artifacts and should be avoided.

摘要

对于有症状的臀部动静脉畸形(AVM),栓塞技术和手术切除已被建议作为治疗选择。我们的目的是评估单次手术切除后的可行性和长期结果。12例患者接受了手术切除,未进行术前栓塞。在这12例患者中,11例手术不完整,其中9例在1至3年前接受过动脉栓塞。所有患者均有症状。计算机断层扫描显示AVM位于细胞间隙,臀肌保留。中位随访时间为80个月。在最后一次随访的计算机断层扫描中,67%的患者没有残留AVM。术前栓塞的使用,尤其是使用不可吸收的栓塞材料(Onyx;美敦力公司,爱尔兰都柏林),由于伪影会使AVM切除和影像学随访更加困难,应避免使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc3f/9661634/95b04023a056/gr1.jpg

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