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目的 探讨颅面部富血管病变的选择性颈外动脉插管治疗技术及其临床效果。方法 采用经皮股动脉穿刺、选择性颈外动脉插管化疗或超选择栓塞术治疗颅面部富血管病变 19例次 ,恶性病变化疗 7例次 (3例加超选择栓塞 ) ,良性病变 12例仅行病灶和供血动脉的栓塞。结果 介入治疗后患者症状均有不同程度的好转 ,15例栓塞治疗者均获供血动脉及病灶的栓塞 ,且 12例栓后造影复查病变完全消失 ,仅 3例仍见部分病变显示。无严重并发症。 14例介入后再行病变切除者发现病灶退缩、术中失血少 ,病理显示病灶及周边血管栓塞和血栓性脉管炎。结论 颈外动脉选择性化疗、栓塞术对颅面部富血管病变是一种安全有效的介入性治疗方法。
Objective To investigate the treatment and clinical effects of selective external carotid artery catheterization for craniofacial angiopathy. Methods Twenty nine patients with craniofacial vascular lesions were treated with percutaneous femoral artery puncture, selective external carotid artery catheterization chemotherapy or superselective embolization. Seven cases of malignant lesions were treated with chemotherapy (3 cases plus superselective embolization), and 12 cases were benign lesions. Only embolization of lesions and feeding arteries. Results After interventional therapy, the symptoms of the patients were improved in different degrees. All the 15 embolization patients received embolization of the feeding arteries and lesions, and 12 cases of angiography showed complete disappearance after thrombectomy. Only 3 cases showed partial lesions. No serious complications. 14 patients who underwent resection of the lesion after interventional intervention found that the lesion regressed and blood loss was minimal. Pathology showed lesions and peripheral vascular embolism and thromboangiitis. Conclusion Selective chemotherapy and embolization of external carotid artery is a safe and effective interventional treatment for craniofacial angiopathy.