Tong Yang-Chao, Zhao Yang, He Hai-Peng, Lin Ren, Lv Jun-Bing, Zhang Yi-Bo, Chen Hui-Ning, Yin Heng-Hui, Qian Jie-Sheng
Department of Interventional Vascular, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Vascular Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Clin Imaging Sci. 2025 May 29;15:19. doi: 10.25259/JCIS_33_2025. eCollection 2025.
Congenital arteriovenous malformations (AVMs) are characterized by abnormal connections between arteries and veins, often presenting challenges in treatment due to their complex vascular structure. Endovascular therapies, including embolization techniques, have become integral in managing AVMs, yet optimal treatment strategies remain under investigation. This retrospective study aimed to evaluate the safety and efficacy of percutaneous glue embolization of n-butyl cyanoacrylate (nBCA) combined with arterial embolization in treating extracranial AVMs.
This retrospective study included 11 patients with extracranial AVMs who underwent percutaneous injection of nBCA glue embolization combined with arterial embolization at our institution between May 2015 and October 2023. Angiographic classification was performed using the Cho-Do vascular imaging system and the Schobinger classification system to categorize the AVMs. Treatment efficacy was assessed based on the percentage of vessel occlusion observed in angiography or imaging studies. The occurrence of major and minor complications was also evaluated.
Eleven patients received 16 treatments, involving a combination of arterial and percutaneous embolization techniques. Five cases achieved complete recovery, while four cases showed significant improvement, resulting in an overall treatment success rate of 81.8%. Favorable outcomes were observed in terms of symptom alleviation and lesion occlusion. Adverse events were minimal, with transient pain and edema being the most common postoperative complaints. Only one case of mild post-operative complication occurred.
Percutaneous glue embolization combined with arterial embolization proves to be a safe and effective treatment modality for extracranial AVMs, with acceptable rates of complications and favorable treatment outcomes.
先天性动静脉畸形（AVM）的特征是动静脉之间存在异常连接，由于其复杂的血管结构，在治疗上常常面临挑战。包括栓塞技术在内的血管内治疗已成为管理AVM的重要组成部分，但最佳治疗策略仍在研究中。这项回顾性研究旨在评估经皮注射氰基丙烯酸正丁酯（nBCA）胶水栓塞联合动脉栓塞治疗颅外AVM的安全性和有效性。
这项回顾性研究纳入了2015年5月至2023年10月期间在本机构接受经皮注射nBCA胶水栓塞联合动脉栓塞的11例颅外AVM患者。使用Cho-Do血管成像系统和Schobinger分类系统进行血管造影分类，以对AVM进行分类。根据血管造影或影像学研究中观察到的血管闭塞百分比评估治疗效果。还评估了主要和次要并发症的发生情况。
11例患者接受了16次治疗，涉及动脉和经皮栓塞技术的联合应用。5例实现完全康复，4例有显著改善，总体治疗成功率为81.8%。在症状缓解和病变闭塞方面观察到了良好的结果。不良事件极少，短暂疼痛和水肿是最常见的术后主诉。仅发生1例轻度术后并发症。
经皮胶水栓塞联合动脉栓塞被证明是治疗颅外AVM的一种安全有效的治疗方式，并发症发生率可接受，治疗效果良好。
