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Objective To evaluate the safety and efficacy of percutaneous ethanol embolization (PEE) in treating arteriovenous malformation (AVM) of foot in children.Methods The clinical data of 11 sick children with arteriovenous malformation of foot,who were treated with PEE in authors' department during the period from January 2007 to January 2016,were retrospectively analyzed.The clinical symptoms,the type of tumor nidus,the therapeutic effect and the postoperative complications were analyzed.Results The 11 sick children included 6 boys and 5 girls,with a mean age of 9 years.Foot mass was seen in 8 children,pain in 8 children,claudication in 3 children and ischemic skin ulcer in one child.Cho Ⅲ b type was observed in 10 children and Cho Ⅱ type in one child;Yakes Ⅳ type was found in 10 children and Ⅱa type in one child.A total of 30 PEE procedures were performed,with an average of 2.7 times per case.The children were followed up for 6-48 months,with a mean of 24 months.Evaluation of curative effect showed that complete cure was achieved in 7 children and partial remission in 3 children,the effective rate was 90.9％.Treatment failure (showing no remission) was seen in one child,and no deterioration of disease was observed.Complications included transient blood oxygen decrease in operation (n=1),toe ischemia (n=1),postoperativeblister (n=1) and local skin ulcer (n=l),no severe complications were observed.Conclusion PEE is a safe and effective treatment for arteriovenous malformation of foot in children.
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Objective To evaluate the therapeutic effects and safety of transcatheter arterial sclerosing embolization (TASE) combined with oral Propranolol in infantile huge hemangiomas.Methods A total of 76 infants with huge hemangioma were treated by TASE.All patients received oral Propranolol based on their weight.The follow-up and efficacy evaluation were performed from the last treatment.And the complications were analyzed.Results Seventy-six cases underwent 95 case-times of TASE totally.The success rate of puncture technique was 100％ (95/95).All patients were divided into 5 levels (0-Ⅳ levels) based on the curative effect of the follow-up,including 6 cases (6/76,7.90％) of level Ⅰ,19 cases (19/76,25.00％) of level Ⅱ,23 cases (23/76,30.26％) of level l,and 28 cases (28/76,36.84％) of level Ⅳ.The total effective rate was 100％ (76/76).There was no serious complications,and the curative effect was stable during the follow-up.Conclusion TASE combined with oral Propranolol in infantile huge hemangiomas is effective with less invasiveness and fewer complications.
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Objective To evaluate the therapeutic effects and safety of transcatheter arterial sclerosing embolization (TASE) combined with oral Propranolol in infantile huge hemangiomas.Methods A total of 76 infants with huge hemangioma were treated by TASE.All patients received oral Propranolol based on their weight.The follow-up and efficacy evaluation were performed from the last treatment.And the complications were analyzed.Results Seventy-six cases underwent 95 case-times of TASE totally.The success rate of puncture technique was 100％ (95/95).All patients were divided into 5 levels (0-Ⅳ levels) based on the curative effect of the follow-up,including 6 cases (6/76,7.90％) of level Ⅰ,19 cases (19/76,25.00％) of level Ⅱ,23 cases (23/76,30.26％) of level l,and 28 cases (28/76,36.84％) of level Ⅳ.The total effective rate was 100％ (76/76).There was no serious complications,and the curative effect was stable during the follow-up.Conclusion TASE combined with oral Propranolol in infantile huge hemangiomas is effective with less invasiveness and fewer complications.
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Objective To evaluate the efficacy and safety of interventional sclerotherapy for intraorbital venous malformation in children. Methods A retrospective analysis of 12 cases with intraorbital venous malformation from March 2007 to July 2013 in our department was made. Twelve lesions including 7 in left eyes and 5 in right eyes were evaluated. Three patients had surgical resection before interventional treatment. Sclerosing agent such as sclerosant foam or pingyangmycin was injected into the lesions guided by DSA. Interventional sclerotherapy was performed once every month until no blood return was observed. Then MRI was used to detect the lesions 1 month after operation. If there were residual lesions in MRI images, then repeat treatment was performed. Postoperative observation included patients' general situation and adverse reactions of eye after each treatment. Results Interventional sclerotherapy were performed to all patients for a total of 42 times (mean time 3.5 ± 1.0 per patient). After a follow?up of 24months, 7 cases were cured, 3 cases improved significantly and 2 cases with partial remission. Postoperative adverse reactions: transient exophthalmos in 39 case?times , peri?orbital and maxillofacial tissue swelling in 32 case?times. No severe complications were observed. Conclusion Interventional sclerotherapy is an easy, safe and effective method for treatment of intraorbital venous malformation.
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Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89％(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.
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ObjectiveTo evaluate and compare the curative effect and the safety of sclerotherapy of venous malformation in children using absolute ethanol and pingyangmycin.MethodsEighty children with venous malformation were treated by sclerotherapy with absolute ethanol or pingyangmycin under general anesthesia during February of 2009 to May of 2011. Diagnostic criteria included the presence of a bluecolored lesion at birth,with gradual increase in its size associated with a positive postural test.MRI showed characteristic imaging features.Eighty patients were divided into two groups by randomization.Forty patients were treated with absolute ethanol,and the remaining 40 patients with pingyangmycin. The therapeutic effects and side effects were observed and recorded during a follow-up period of 6 to 24 months ( average 15 months).Treatment results weredividedinto four categories: cure, basiccure, effective, and ineffective,and the former three categories were considered effective in treatment.Chi-square test was used to compare the rate of effective treatment and rate of complications in these two groups.ResultsThe effective patients treated with absolute ethanol was 38 (95.0％,38/40),and the effective patients with pingyangmycin was 26(65.0％,26/40),x2 test ( x2 =11.25,P ＜ 0.01 ) difference was statistically significant.Eight patients developed skin necrosis; 4 patients serious local swelling,2 patients muscle fibrosis,1 patient cerebral embolism in the absolute alcohol group.Two patients developed postoperative fever and vomiting and 2 skin necrosis in the pingyangmycin group,the difference was statistically significant (x2 =12.29,P ＜0.01 ). ConclusionsSclerotherapyiseffectiveforthetreatmentofvenousmalformationsin children.Absolute ethanol is more effective,but associated with more complications,such as skin necrosis or as serious as cerebral embolism,than pingyangmycin.
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Objective To explore the effect and safty of interventional embolization of congenital arteriovenous fistula (CAVF) in the common femoral profounda artery in children.Methods Eight children (aged 6 to 14 years ;6 males and 2 females) with CAVF underwent interventional embolization From January 2006 and December 2010.Color Doppler sonography and DSA were performed on all patients.Arterial duplex imaging revealed the arteriovenous fistula in the common femoral profounda artery and DSA further confirmed the presence of an AVF over the common femoral profounda artery via the other vein.All children were treated with interventional embolization therapy by the injection ofcoils or ethanol through a microcather.It was necessary to performed repeated interventional embolization if the lesion was not obliterated in 4 weeks.All patients were followed-up from 6 months to 2 years and the clinical symptoms were observed.Results Arteriograpy can clearly demonstrate the femoral profounda artery and its branches as well as the fistula.Ten interventional embolization procedures were performed.Forty seven coils were deployedduring the procedure and seven ethanol embolization procedures were performed.Post-procedural angiography revealed complete occlusion in 8 patients.No major complications such as ectopic coil embolization,tissue necrosis,peripheral nerve palsy or cardio-pulmonary collapse were found.The abnormal AVFs were embolized completely in 7 cases after only one therapy and there was no recurrent disease in the 6 months to 2 years follow-up.Some tiny AVFs were still found in another case which underwent three additional treatments.However,the clinical symptoms were under control.Conclusion Interventional embolization is a safe and effective therapeutic method for CAVF of the common femoral profounda artery in children and it might become the primary treatment option.