摘要
目的 探讨外周动静脉畸形介入栓塞硬化治疗后去血管化程度与临床转归之间的关系.方法 回顾性分析2021年7月至2023年6月收治的37例外周动静脉畸形患者的临床资料,均接受了"瘤巢"和(或)回流静脉栓塞联合硬化剂注射的治疗方法,通过2名具有5年以上外周血管介入经验的医师对治疗前后去血管化程度进行判断,与随访的临床转归进行相关性研究.结果 37例均为有症状患者,肿胀、疼痛的占比为75.7％,26例接受了 1次治疗,3例接受了 2次介入栓塞及硬化治疗,平均随访(13.3±5.0)个月,临床症状完全缓解14例,部分缓解22例,总体有效率为97％,去血管化程度＜50％的6例,50％～75％的患者16例,75％～90％的患者5例,＞90％的患者10例.低于60％的去血管化程度无法达到临床症状的缓解.结论 外周动静脉畸形介入治疗的去血管化程度与临床转归之间存在正相关性,60％的去血管化程度可作为治疗有效性的"界值".
Abstract
Objective To explore the relationship between the degree of devascularization and clinical outcomes after interventional embolization and sclerotherapy for peripheral arteriovenous malformations.Method A retrospective analysis was conducted on the data of 37 patients with peripheral arteriovenous malformations admitted at Department of Cardiovascular Surgery,China-Japan Friendship Hospital from July 2021 to June 2023.All patients received the treatment of"nidus"and/or outflow veins embolization combined with sclerotherapy injection.Two experienced physicians evaluated the degree of devascularization before and after treatment,and conducted a correlation study with clinical outcomes after follow-up.Result All 37 patients were symptomatic.Swelling and pain accounted for 75.7％of all the cases.Twenty-six patients received only one procedure,3 patients received re-interventional treatments.The average follow-up time was(13.3±5.0)months.Clinical symptoms were completely relieved in 14 patients,and partial relief in 22 patients.The overall effective rate was 97％.There were 6 patients with degree of de vascularization＜50％during procedure,16 patients with degree of 50％-75％,and 5 patients with degree of 75％-90％,10 cases with degree over 90％.Patients with devascularization degrees less than 60％can not achieve clinical symptom relief.Conclusions There is a positive correlation between the degree of devascularization and clinical outcomes in the interventional embolization and sclerotherapy of peripheral arteriovenous malformations,and 60％of the degree of devascularization can serve as the"threshold"for effectiveness of treatment.
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