Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Vasc Surg Venous Lymphat Disord. 2023 Jul;11(4):809-815. doi: 10.1016/j.jvsv.2022.10.019. Epub 2023 Apr 17.
In the present study, we summarize our experience in locating the nidus of arteriovenous malformations (AVMs) with a dominant outflow vein (DOV) in the lower extremities and eradicating the nidus with ethanol and coils.
Twelve patients with lower extremity AVMs who underwent ethanol embolization combined with DOV occlusion from January 2017 to May 2018 were enrolled in the present study. Selective angiography was used to locate the nidus of the AVMs, which was eradicated using ethanol and coils via the direct puncture pathway. All treated patients underwent postoperative follow-up (mean, 25.5 months; range, 14-37 months).
The 12 patients underwent a total of 29 procedures (mean, 2.4; range, 1-4) with 27 detachable coils and 169 Nester coils (Cook Medical Inc, Bloomington, IN). Of the 12 patients, 7 (58.3%) had a complete response and 5 (41.7%) a partial response. Three patients (25%) had minor complications such as blister and superficial skin ulcers during follow-up. However, they recovered spontaneously and completely. No major complications were recorded.
Ethanol embolization combined with coil-assisted DOV occlusion has the potential to eradicate the nidus of lower extremity AVMs with acceptable complication rates.
在本研究中，我们总结了在下肢具有优势流出静脉（DOV）的动静脉畸形（AVM）病灶定位和使用乙醇及线圈进行根治的经验。
本研究纳入了 2017 年 1 月至 2018 年 5 月期间接受乙醇栓塞联合 DOV 闭塞治疗的 12 例下肢 AVM 患者。采用选择性血管造影定位 AVM 病灶，通过直接穿刺途径使用乙醇和线圈进行根治。所有接受治疗的患者均进行了术后随访（平均 25.5 个月；范围 14-37 个月）。
12 例患者共进行了 29 次手术（平均 2.4 次；范围 1-4 次），使用了 27 个可解脱线圈和 169 个 Nester 线圈（库克医疗公司，印第安纳州布卢明顿）。12 例患者中，7 例（58.3%）完全缓解，5 例（41.7%）部分缓解。3 例（25%）患者在随访期间出现轻微并发症，如水疱和浅表皮肤溃疡，但均自行完全恢复。无重大并发症记录。
乙醇栓塞联合线圈辅助 DOV 闭塞有可能根治下肢 AVM，且并发症发生率可接受。
