ABSTRACT
In article experience of diagnostics and treatment of 30 patients with angiodysplasia of the tongue was given. The surgical treatment was made to 21 patients with vascular malformation of the tongue, selective bilateral catheterization of lingual arteries and endovascular microembolization by PVA - 250-400 µ was successfully performed in 4 cases, transcutaneus sclerotherapy with solution aethoxyskleroli 0,5% in 3 cases was successfully provided. Advantages of endovascular diagnostics and treatment methods angiodysplasias of the tongue were shown.
Subject(s)
Angiodysplasia/diagnosis , Angiodysplasia/surgery , Tongue Diseases/diagnosis , Tongue Diseases/surgery , Tongue/blood supply , Tongue/surgery , Angiodysplasia/pathology , Endovascular Procedures , Female , Humans , Male , Middle Aged , Tongue/pathology , Tongue Diseases/pathology , Treatment OutcomeABSTRACT
Surgical intervention is the only method of radical treatment of carotid paraganglioma (CP). Intraoperative blood loss may exceed 2 litters. Ligation of the external carotid artery (ECA) is not always possible technically due to tumour invasion to the ECA's walls. Prior to operation, in order to diminish blood loss it is suggested to perform endovascular embolization (EE) of the vessels feeding the tumour. The case report presented herein concerns an 18-year-old male patient with CP after comprehensive diagnosis including ultrasonographic duplex scanning with Doppler colour mapping, enhanced-contrast spiral computed tomography, selective carotid angiography. The patient was subjected to selective. EE of the afferent vessels of CP. Embolization of the branch of the ascending pharyngeal artery travelling to the lower pole of the tumour, and that of the large branches feeding the upper pole of the tumour from the initial portion of the occipital artery with poly vinyl alcohol (PVA-300) and hydrogel "Embox" was followed by surgical intervention: removal of the tumour, closure of the ostia of the tumour's own arteries, ligation of the EC A. The volume of intraoperative blood loss amounted to 350 ml. The postoperative period proved uneventful with nothing to report. During the check-up examinations of the patient, performed 3, 6, 12 and 24 months after the operation, a good postoperative therapeutic outcome was noted to persist.
Subject(s)
Carotid Body Tumor/therapy , Paraganglioma/therapy , Adolescent , Blood Loss, Surgical , Carotid Body Tumor/surgery , Embolization, Therapeutic , Female , Follow-Up Studies , Humans , Male , Paraganglioma/surgery , Time Factors , Treatment OutcomeABSTRACT
Two cases of combined treatment of auricular vascular neoplasms (arteriovenous malformation and hemangioma) are presented. Their two-step management included endovascular microembolization of the posterior auricular artery with polyvinyl alcohol (PVA 300, 500 mcm) and surgical resection of the tumour. The results confirm the feasibility of combination of traditional and endovascular surgery for the treatment of this pathology. Preoperative endovascular microembilization not only arrests hemorrhage from angiodysplasia but also decreases its size and isolates it from healthy tissues. Embolization of the posterior auricular artery can be performed only after the comprehensive angiographic evaluation of the blood flow in angiodysplasia and the adjacent vessels using superselective catheterization and officinal emboli.
Subject(s)
Ear Auricle , Ear Neoplasms/therapy , Embolization, Therapeutic/methods , Hemangioma, Capillary/therapy , Otologic Surgical Procedures/methods , Adult , Angiography , Ear Neoplasms/diagnosis , Female , Follow-Up Studies , Hemangioma, Capillary/diagnosis , HumansABSTRACT
The article deals with the description of a rare clinical case wherein a 44-year-old female patient presenting with bleeding capillary angioma of the left auricle obstructing the auditory passage was fist subjected to endovascular microembolization of the posterior auricular artery by means of polyvinyl alcohol (PVA-500), followed by a second stage of virtually bloodlessly surgical removal of the tumour carried out five days thereafter. This case report once again points to feasibility of combined, i. e. endovascular and conventional surgical management of capillary angiomas. Preoperative microembolization of a bleeding haemangioma arrests haemorrhage from the tumour, resulting in the decreased size thereof, as well as leading to circumscribing the tumour from healthy tissue. Attention is paid to the fact that embolization of the auricular artery should be performed only after a thorough angiographic evaluation of the pattern of the blood flow in the tumour and adjacent vessels by means of the technique of selective catheterization and using only the officinal emboli.
