Osuga Keigo, Yokota Naoki, Yamamoto Kazuhiro, Matsutani Hiroki, Yamamoto Kiyohito, Juri Hiroshi, Ozawa Hideki, Katsumata Takahiro
Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Japan.
Department of Thoracic and Cardiovascular Surgery, Osaka Medical and Pharmaceutical University, Japan.
Interv Radiol (Higashimatsuyama). 2024 Feb 8;9(1):26-30. doi: 10.22575/interventionalradiology.2023-0021. eCollection 2024 Mar 1.
A 40-year-old man was incidentally found to have right-sided pelvic arteriovenous malformation (AVM) with an aneurysmal dominant outflow vein (DOV). The AVM had two main feeding arteries forming a cluster of fine vessels shunt to the DOV. As transvenous approach was impossible due to anatomical difficulty, transarterial ethanol embolization was performed under simultaneous double microballoon occlusion of the two feeding arteries in combination with protective coil embolization of the prostatic branches. Ethanol (13 mL) was intermittently injected from both microballoon catheters until the AV shunt was completely occluded. At 1-year follow-up, contrast-enhanced CT revealed shrinkage of the thrombosed DOV without any symptom. Our case demonstrated the usefulness of simultaneous double microballoon-occluded ethanol embolization for treating a localized pelvic AVM with a few feeding arteries.
一名40岁男性偶然发现右侧盆腔动静脉畸形（AVM），其引流静脉为动脉瘤样优势引流静脉（DOV）。该AVM有两条主要供血动脉，形成一簇细小血管分流至DOV。由于解剖结构困难无法采用经静脉途径，遂在对两条供血动脉同时进行双微球囊闭塞并联合对前列腺分支进行保护性弹簧圈栓塞的情况下，实施经动脉乙醇栓塞术。从两个微球囊导管间歇性注入乙醇（13毫升），直至动静脉分流完全闭塞。随访1年时，增强CT显示血栓形成的DOV缩小，且无任何症状。我们的病例证明了同时双微球囊闭塞乙醇栓塞术在治疗具有少数供血动脉的局限性盆腔AVM中的有效性。
