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基于文献综述和我们的临床经验,对上颌动脉假性动脉瘤的放射影像学与外科治疗的对比分析

A Comparative Analysis of Radiological Imaging and Surgical Treatments for Maxillary Artery Pseudoaneurysms, Based on a Literature Review and Our Clinical Experience.

作者信息

Samól Kinga, Michcik Adam, Wojciechowska Barbara, Polcyn Adam, Garbacewicz Łukasz, Drogoszewska Barbara

机构信息

Department of Maxillofacial Surgery, University Clinical Centre in Gdańsk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland.

Department of Maxillofacial Surgery, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland.

出版信息

Biomedicines. 2025 Jun 9;13(6):1410. doi: 10.3390/biomedicines13061410.

Abstract

: A pseudoaneurysm forms as a result of disruption of all artery wall layers. In the head and neck, they are most commonly found in the maxillary artery. Due to their location and associated symptoms, detailed radiological imaging is necessary to determine the nature and extent of lesions. Various treatment methods are available. : To systematize symptoms, diagnostics, and treatment methods, a literature review from databases spanning 2014 to 2024 was conducted, with 30 articles included in the study. : The factors that caused MAPs included facial trauma (n = 33; 66%), iatrogenic surgical procedures (n = 14; 28%), head and neck radiotherapy (n = 1; 2%), infection (n = 1; 2%), and one case due to an idiopathic factor (n = 1; 2%). Diagnostic imaging included computed tomography with contrast, magnetic resonance imaging, and angiography. Treatment methods used: endovascular embolization (n = 44; 88%), surgical resection (n = 3; 6%), cauterization (n = 2; 4%), and compression tamponade (n = 1; 2%). Interestingly, three of the cases were treated with endoscopic access (6%). : It can be concluded that the most common cause of MAPs is trauma to the facial skeleton, and the most frequently used treatment method is endovascular embolization. Given the need for detailed MAP imaging and treatment in specialized invasive radiology departments, patients with MAPs should be treated in multidisciplinary clinical centers.

摘要

假性动脉瘤是由于动脉壁各层均被破坏而形成的。在头颈部,它们最常见于上颌动脉。由于其位置和相关症状,需要详细的放射影像学检查来确定病变的性质和范围。有多种治疗方法可供选择。为了使症状、诊断和治疗方法系统化,我们对2014年至2024年数据库中的文献进行了综述,该研究纳入了30篇文章。导致医源性假性动脉瘤的因素包括面部创伤(n = 33;66%)、医源性手术操作(n = 14;28%)、头颈部放疗(n = 1;2%)、感染(n = 1;2%)以及1例特发性因素导致的病例(n = 1;2%)。诊断性成像包括增强计算机断层扫描、磁共振成像和血管造影。所采用的治疗方法:血管内栓塞(n = 44;88%)、手术切除(n = 3;6%)、烧灼(n = 2;4%)和压迫填塞(n = 1;2%)。有趣的是,其中3例采用了内镜入路治疗(6%)。可以得出结论,医源性假性动脉瘤最常见的原因是面部骨骼创伤,最常用的治疗方法是血管内栓塞。鉴于医源性假性动脉瘤的详细成像和治疗需要在专门的介入放射科进行,医源性假性动脉瘤患者应在多学科临床中心接受治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5442/12190534/26c64869d776/biomedicines-13-01410-g001.jpg

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