Onyx栓塞治疗小儿下肢动静脉畸形1例
海南省妇女儿童医学中心, 儿科, 海南海口 570000
| 摘 要： | 目的：探讨Onyx栓塞治疗小儿下肢动静脉畸形的疗效与安全性。方法：回顾性分析1例3岁男性下肢动静脉畸形患儿应用Onyx栓塞治疗前后的临床资料。结果：患儿出现左大腿外侧疼痛伴生长缓慢的软组织肿块约2年，1年前有局部溃疡和出血病史。二维超声和彩色多普勒超声心动图显示左大腿外侧的皮下组织可见一形态不规则的软组织团块，边界不清，有丰富的血流信号，病灶可测及动脉谱和静脉谱血流。下肢动脉CT血管造影（CTA）显示，左大腿外侧见一个不规则和异常强化血管肿块，病灶范围约3.9厘米×2.4厘米×1.0厘米，由股深动脉、腘动脉和膝关节外侧动脉分支供血，并引流入大隐静脉。患儿被确诊为左下肢动静脉畸形。在全麻下，操控马拉松微导管（Medtronic-ev3）到达左大腿动静脉畸形的供血动脉。Onyx-18通过马拉松微导管（Medtronic-ev3）注射，以0.10~0.15ml/分钟的速度注射Onyx-18至完全填充病灶腔室，然后向后填充多个供血动脉分支的末端。应用Onyx栓塞治疗后，患儿左下肢病灶局部肿胀2周后消退。临床随访6个月，无局部疼痛、溃疡或出血。结论：Onyx栓塞是一种安全有效的治疗肢体AVMs的方法。 |
| 关 键 词： | 栓塞治疗; Onyx; 肢体; 动静脉畸形 |
| DOI： | 10.57237/j.cmf.2024.01.001 |
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收稿日期: 2023-11-17
接受日期: 2023-12-27
在线出版日期: 2024-01-20
Embolotherapy with Onyx for Lower Limb Arteriovenous Malformation in a Child: Case Report
Paediatrics Department, Hainan Women and Children's Medical Center, Haikou 570000, China
| Abstract: | Objective: To explore the efficacy and safety of Onyx embolization in pediatric lower limb arteriovenous malformations (AVMs). Methods: The clinical data of a 3-year-old boy with AVMs were analyzed before and after Onyx embolization. Results: The child slowly developed a soft tissue mass with pain in the lateral left lateral thigh for approximately 2 years and had a history of local ulceration and bleeding 1 year ago. Two-dimensional ultrasound and color Doppler echocardiography showed an irregular soft tissue mass in the subcutaneous tissue of the right thigh, with unclear borders, rich blood flow signals, measurable arterial and venous blood flow. Lower extremity artery CT angiography (CTA) showed an irregular and abnormally enhanced vascular mass in the lateral left thigh with a lesion of about 3.9 cm * 2.4 cm * 1.0 cm, supplied by the deep femoral, popliteal and lateral knee arteries, and drained into the great saphenous vein. The child was confirmed with AVMs of the left lower limb. Under general anesthesia, the Marathon micro-catheter (Medtronic-ev3) was controlled to reach the feeding artery of the arteriovenous malformation of the left thigh. Onyx-18 was injected through the marathon microcatheter (Medtronic-ev3) at a speed of 0.10~0.15ml per minute to fully fill the focal chamber and then backward to fill the end of multiple branches of the feeding arteries. After Onyx embolization, the local swelling of the left lower limb lesion in the child resolved after 2 weeks. After 6 months of clinical follow-up, there was no local pain, ulcers, or bleeding. Conclusion: Onyx embolization is a safe and effective treatment for limb AVMs. |
| Keywords: | Embolo-Therapy; Onyx; Limb; Arteriovenous Malformations |
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