【摘要】 目的探讨肺动静脉畸形弹簧圈栓塞治疗后复发类型及再次栓塞治疗的临床意义。方法回顾性分析经导管弹簧圈栓塞治疗的21例肺动静脉畸形患者的临床与影像学资料。肺动静脉畸形弹簧圈栓塞术后复发类型主要包括已栓塞供血血管的再通、邻近肺动脉侧支血管形成肺动脉-肺动脉的再灌注及栓塞不全(复杂的肺动静脉畸形,漏栓或微小供血血管生长增粗)。结果 21例患者共79个肺动静脉畸形,其中9例14个肺动静脉畸形复发后再次经导管栓塞治疗。9个复发的肺动静脉畸形为已栓塞供血血管的再通,4个为邻近肺动脉侧支血管形成肺动脉-肺动脉的再灌注,1个为栓塞不全。血管构筑、弹簧圈数目及供血血管的直径与栓塞术后复发类型无明显相关性。弹簧圈与瘘口距离与两者复发有关。结论经导管弹簧圈成功栓塞肺动静脉畸形后最常见的复发类型为已栓塞供血血管的再通,其次为肺动脉-肺动脉的再灌注,均可以经导管再次栓塞治疗。更多还原

【Abstract】 Objective To study the Clinical significance of retreatment and recurrence patterns in treated pulmonary arteriovenous malformations by Coil embolization. Methods The clinial and imaging data of 21 patients with pulmonary arteriovenous malformations treated by coil embolization between March 2005 and July 2015 were retrospectively analyzed.The recurrent types of pulmonary arteriovenous malformations after embolization include the recanalization of the embolized vessels,pulmonary-to-pulmonary reperfusion of the small feeders from adjacent normal pulmonary arteries,and incomplete primary treatment,in which there were previously untreated feeders or complex pulmonary arteriovenous malformations orsmall blood vessel growth. Results 14 recurrent PAVMS of 9 patients from 79 PAVMs of 21 patients were retreated by Coil embolization successfully. Recanalization of the embolized vessels occured in 9 PAVMS,Pulmonary-to-pulmonary reperfusion of the small feeders from adjacent normal pulmonary arteries occured in 4 PAVMs,incomplete primary treatment occurred in 1 PAVMs. Angioarchitecture,coil number,and feeder diameter did not significantly differ between recanalization of the embolized vessels and pulmonary-to-pulmonary reperfusion PAVMs. Coil-sac distance was related to the recurrence of both of them. Conclusion The recanalization of the embolized vessels is the most common recurrence patterns,Pulmonary-to-pulmonary reperfusion is less common,both of them can be retreated by Coil embolization successfully.更多还原