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OBJECTIVE To discuss the efficacy and safety of Onyx embolization for the treatment of maxillofacial arteriovenous malformation(mAVMs). METHODS Between February 2013 to May 2014, 16 patients with mAVMs received embolotherapy in our department. Eight cases' mAVMs located in mandibular region, 5 cases located in the maxillary region and the other 3 cases located near the orbital region. Embolotherapy with Onyx was carried out in all patients and all the patients were followed-up. The effect of embolization was evaluated according to the deformity arteriolar blood flow. RESULTS After the embolization, angiograpy showed that complete occlusion of mAVMs was achieved in 3 cases, 50%-90%occlusion in 10 cases, <50% occlusion in 3 cases, and the overall response rate was 81.25% (13/16). After operation, temporary decreased vision was obtained in one patient and recovered after 20 days, no permanent visual abnormality was found in all of the cases. Complications as distending pain, fever disappeared in 13 patients, improved in 2 patients and became worse in one patient. There was no case of skin necrosis occurred. Follow-up for 6 months after treatment, the deformity arteriolar blood flow larger than before was found in 2 cases and the others were stable. CONCLUSION Onyx embolization for the treatment of maxillofacial arteriovenous malformation is a safe and effective method, the short term curative effect has been confirmed while the long term curative effect should be further evaluated.
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Objective To investigate the clinical effect of endovascular embolization in treating spinal dural arteriovenous fistulae, and to discuss its imaging manifestations. Methods A total of 7 patients with spinal dural arteriovenous fistulae were included in this study. Endovascular embolization was carried out in all the 7 patients. The clinical data, including epidemiology, spinal MRI and DSA manifestations, therapeutic method and follow-up findings, were retrospectively analyzed. Results Abnormal MRI manifestations of spinal cord were demonstrated in all 7 patients. After the diagnosis was confirmed by DSA, endovascular embolization was carried out. All patients were followed up for 6 months, and their clinical symptoms were improved in different degrees. N-butyl cyanoacrylate (NBCA) glue was used as embolization agent in 4 cases, and no recurrence was observed in them. Onyx liquid glue was used in 3 patients, and in one of them the arteriovenous fistula recurred. Conclusion For the treatment of spinal dural arteriovenous fistulae, endovascular embolization is effective and safe although further investigation is still needed.
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<p><b>OBJECTIVE</b>To investigate the efficacy of detachable balloon for splenic artery trunk embolization in patients with cirrhotic portal hypertension and hypersplenism.</p><p><b>METHODS</b>Eight patients with cirrhotic portal hypertension received splenic artery trunk disconnection using detachable balloons under the guidance of digital subtraction angiography. The diameter and blood flow of the portal vein, the superior mesenteric vein, the splenic vein and the hepatic artery were measured by color Doppler ultrasound. Markers of liver function and blood coagulation, and routine blood parameters were assessed. Gastroscopy was used to evaluate to the degree of gastroesophageal varices. All complications experienced during the perioperative period were recorded.</p><p><b>RESULTS</b>The portal vein diameter decreased from 1.55±0.38 cm to 1.55±0.38 cm, and the splenic artery diameter decreased from 1.45±0.10 cm to 1.41±0.09 cm (P < 0.05). The portal vein blood flow was reduced from 971.52±174.77 ml/min to 785.86±100.17 ml/min, and the splenic vein blood flow decreased from 938.01±208.86 ml/min to 644.02±188.15 ml/min, while the hepatic artery blood flow increased from 261.25±65.47 ml/min to 449.32±84.05 ml/min (P < 0.05). The symptoms of splenism were improved effectively, with platelet counts rising from 37.75±10.61*109/L to 138.63±28.22*109/L after the procedure (P < 0.05). There were no episodes of severe complications or death in the perioperative period, and all patients showed remarkable improvement in markers of liver function and coagulation function, and improvement of esophagogastric varices.</p><p><b>CONCLUSIONS</b>The interventional disconnection technique of the splenic artery trunk using detachable balloon for the treatment of portal hypertension and hypersplenism is safe and effective.</p>