Yamamoto Y, Ohura T, Minakawa H, Sugihara T, Yoshida T, Nohira K, Shintomi Y
Department of Plastic and Reconstructive Surgery, School of Medicine, Hokkaido University, Sapporo, Japan.
Plast Reconstr Surg. 1994 Sep;94(3):476-82. doi: 10.1097/00006534-199409000-00009.
Fourteen patients with arteriovenous malformations were treated with surgical resection followed by well-vascularized tissue transfer. Free-tissue transfers were used in 12 of the patients and axial local flaps in 2 patients to reconstruct the region with arteriovenous malformations. The feeding arteries of the arteriovenous malformations were used as recipient vessels in all cases of free-tissue transfers without any trouble in microvascular anastomosis. With an average follow-up of 3 years and 2 months, 12 patients showed no clinical recurrence (86 percent). Follow-up angiography in seven patients showed complete disappearance of malformations in two patients and residual malformations not enlarged in three patients. Two patients had residual malformations that were noted to be increasing in follow-up angiograms, and they also had clinical evidence of recurrence. In these patients an intramaxillary recurrence in one and intraorbital in the other appeared at about 1 and 3 years, respectively, after surgery. This therapeutic concept can be expected to provide great remission in the treatment of arteriovenous malformations.
14例动静脉畸形患者接受了手术切除，随后进行了血运丰富的组织移植。12例患者采用了游离组织移植，2例患者采用了轴型局部皮瓣来重建动静脉畸形区域。在所有游离组织移植病例中，均将动静脉畸形的供血动脉用作受区血管，微血管吻合均顺利完成。平均随访3年零2个月，12例患者无临床复发（86%）。7例患者的随访血管造影显示，2例患者的畸形完全消失，3例患者的残余畸形未增大。2例患者有残余畸形，在随访血管造影中发现其在增大，且有临床复发证据。在这些患者中，1例患者术后约1年出现上颌内复发，另1例患者术后约3年出现眶内复发。这种治疗理念有望在动静脉畸形的治疗中取得显著缓解效果。
