Embolization of cerebral arteriovenous malformations achieved with polyvinyl alcohol particles: angiographic reappearance and complications.

BACKGROUND AND PURPOSE: The appropriate choice of embolic materials with respect to the permanency of obliterated nidi after embolization and complications related to the procedure is essential for safe and effective embolization of cerebral arteriovenous malformations (AVMs). Our purpose was to ascertain the recanalization and complication rates after AVM treatment with polyvinyl alcohol (PVA) particles. METHODS: Between 1988 and 1994, 36 AVMs were embolized with PVA particles at our institution. Follow-up angiographic findings and occurrence of complications during the embolization procedures were analyzed retrospectively. RESULTS: Complete obliteration of the nidus immediately after embolization was achieved in five patients, and 80% to 99% obliteration was attained in 12 patients. Fifty-one follow-up angiographic examinations were performed 1 week to 60 months (mean, 7 months) after embolization in 31 patients. An increase in nidal size was seen on 15 follow-up angiograms (29%) and a decrease was seen in seven (14%). In 28 of the 51 angiograms obtained more than 1 month after follow up (mean, 13 months), 12 (43%) showed AVM enlargement. In four (80%) of five cases of complete obliteration, nidi reappeared on follow-up angiograms. Hemorrhagic complications occurred in three cases and ischemic ones in seven. One patient (3%) died and five (14%) suffered persistent neurologic deficits. CONCLUSION: Embolization with PVA particles can produce significant volume reduction in AVM nidal size, but recanalization is a distinct possibility.     

Dissolution of isobutyl 2-cyanoacrylate on long-term follow-up

Eight patients with arteriovenous malformations (AVMs) in the basal ganglionic and deep parietooccipital regions and one patient with an AVM in the shoulder region showed resorption of the isobutyl 2-cyanoacrylate cast and recanalization of the arteries after delayed follow-up angiography. All the AVMs were large, had multiple arterial pedicles, and revealed significant obliteration of the AVM immediately after embolotherapy. Although a 50-75% obliteration was achieved immediately after embolization, follow-up angiography 6-20 months later revealed almost the original status. The residual bucrylate cast was disproportionately small compared with the recanalized malformation in seven patients, while in two patients there was no evidence of bucrylate on plain films. Degradation of bucrylate probably is due to the lysosomal activity of the endothelial cells. The results from our nine patients with some degree of resorption of isobutyl 2-cyanoacrylate and six with recanalized AVMs 6-20 months after embolization suggest that operable AVMs should be excised soon after embolotherapy and inoperable AVMs should be embolized as completely as possible.     

Treatment of arteriovenous malformations of the brain with combined embolization and stereotactic radiosurgery: results after 1 and 2 years

Seven patients with large arteriovenous malformations (AVMs) of the brain were selected for combined therapy with particulate embolization, followed by radiosurgery of the residual nidus. The goal of embolization was to reduce the patient nidus to a size that facilitated successful stereotactic radiosurgery. Angiograms obtained 1 and 2 years after radiosurgery were evaluated for changes in nidus size, flow rate, and feeding and draining vessels. One year after stereotactic radiosurgery, one AVM was angiographically undetectable. Three other AVMs demonstrated a volume reduction of greater than 50%, in addition to decreased shunt speed and altered angioarchitecture at 1-year follow-up. At 2-year follow-ups, two of seven AVMs were cured, and an additional two of seven had a greater than 98% reduction in nidus volume. Although one patient experienced a transient deficit from embolotherapy, none of our patients suffered a new neurologic deficit or a hemorrhage during the follow-up period. Our data support the efficacy of combined embolotherapy and radiosurgery for definitive therapy of selected large AVMs of the brain.     

Uterine artery embolization in sheep: comparison of acute effects with polyvinyl alcohol particles and calibrated microspheres

PURPOSE: To compare the effects on the myometrium of polyvinyl alcohol (PVA) particles and calibrated microspheres (MS) in embolization of the uterine arteries in sheep. MATERIALS AND METHODS: Superselective and bilateral embolization of the uterine arteries was performed with PVA particles and calibrated MS within 24 hours after artificial ovulation in 26 adult nonpregnant sheep. PVA particles of four diameters, 150-250, 250-400, 400-600, and 600-1,000 microm, were compared with calibrated MS of similar diameters, 100-300, 300-500, 500-700, and 700-900 microm, in eight groups of sheep. Evaluation was based on histopathologic study of uterus, ovaries, and vascular pedicles after sacrifice 5 days after embolization. The scores of necrosis, the diameter of occluded arteries, and the number of particles were determined. The scores of uterine necrosis were compared by using nonparametric tests (Mann-Whitney U and Kruskal-Wallis). Spearman rank test was used for correlations. RESULTS: PVA particles clumped more readily than did MS. Small particles had a higher score (P =.02) of uterine necrosis than did large particles. PVA particles produced more necrosis than did MS. Size of MS and diameter of occluded arteries showed significant correlation (rho = 0.762, P <.001). Size of PVA particles and diameter of occluded arteries showed no correlation. PVA particles occluded vessels of a wider range of size than did calibrated MS. CONCLUSION: PVA particles are associated with intense uterine necrosis and extensive arterial occlusion regardless of size. Calibrated MS, which are associated with less uterine necrosis, permit a segmental arterial occlusion correlated with size.     

Efficacy of embolization in traumatic uterine vascular malformations

PURPOSE: To evaluate the efficacy of embolotherapy in patients with bleeding traumatic uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: A retrospective review of all patients who underwent pelvic arterial embolization at our institution between July 1992 and September 2002 was performed. Fifteen patients were diagnosed with a uterine vascular malformation on duplex ultrasonography and correlative MR imaging. Serial beta-human chorionic gonadotropin levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of the uterine arteries. Embolizations were performed with use of standard 4-5-F catheters and microcatheters when necessary. Embolic agents in the 25 procedures included glue only (n = 13), polyvinyl alcohol (PVA) particles and glue (n = 4), PVA particles (n = 2), Gelfoam (n = 2), coils (n = 1), PVA particles and coils (n = 1), glue and Gelfoam (n = 1), and glue and coils (n = 1). PVA particle size ranged from 350 to 1,000 micro m. Outcomes assessed were cessation of bleeding, persistence or resolution of the AVM, complications, and pregnancy after embolization. These were assessed by chart, laboratory, and imaging reviews. RESULTS: A total of 25 embolization procedures were performed in 15 patients. Six patients required repeat embolization (one patient underwent embolization on six occasions; five patients had two embolization procedures each) for recurrence of bleeding. Sixteen procedures were performed on an elective basis and nine were performed on an emergent basis. The technical success rate of embolization was 100%. The clinical success rate was 93%: bleeding was controlled in 14 of 15 patients and one patient underwent a hysterectomy. Four of the 15 patients subsequently had a total of five uneventful intrauterine pregnancies carried to term. The 14 patients who underwent successful embolization had no recurrence of bleeding at a median follow-up of 53 months (range, 3-124 months) after treatment. Three patients were eventually lost to follow-up. One minor complication (0.4%) of non-flow-limiting dissection of the internal iliac artery occurred. CONCLUSION: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. This procedure allows for preservation of uterine function with the possibility of future pregnancy and should be considered as a primary treatment option.     

Embolization of hepatic arteriovenous malformations using radiolabeled and nonradiolabeled polyvinyl alcohol sponge in a patient with hereditary hemorrhagic telangiectasia: case report.

Polyvinyl alcohol sponge (PVA) radiolabeled with 99mTc-sulfur colloid was used to evaluate a large hepatic arteriovenous malformation (AVM) in a 71-yr-old white female prior to embolization. The patient had hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu) with severe left-to-right shunting through the hepatic AVM which resulted in high-output congestive heart failure. The patient also had severe pulmonary hypertension. Scintigraphic imaging of the embolized radiolabeled PVA particles allowed us to be certain that the particles did not flow through the liver and inadvertently embolize the lungs; with the patient's already poor pulmonary status, embolization could have been fatal.     

Low-dose particulate polyvinylalcohol embolization in massive small artery intestinal hemorrhage. Experimental and clinical results

The branches of the superior mesenteric artery were embolized with polyvinylalcohol (PVA) particles 149 to 250 mu (small), 420 to 590 mu (medium), and 590 to 1000 mu (large), respectively, in three groups of dogs. In the small PVA particle group, all three dogs died. In the medium and the large PVA particle groups, nine of the 11 dogs showed no significant ischemic change and the remaining two (one dog in the medium PVA group and one in the large PVA group) had a superficial ulcer. This study suggests that PVA embolization can be performed safely if particles of 420 mu or larger are used. In clinical studies, large PVA particles were used in embolization therapy for massive intestinal hemorrhage from small arteries in five patients. All had the hemorrhage from ulcer disease in the small bowel (four patients) and the ascending colon (one patient). Three patients were completely controlled with no recurrence of hemorrhage. The remaining two experienced rebleeding after embolization. No major complication was found in this series. It is concluded that low-dose large PVA particles are suitable as an embolic material for transcatheter occlusion of small-artery intestinal hemorrhage.     

Particle embolization of hepatic neuroendocrine metastases for control of pain and hormonal symptoms

PURPOSE: To evaluate treatment outcome with respect to the indication for treatment in patients with neuroendocrine tumors metastatic to the liver undergoing hepatic artery embolization with polyvinyl alcohol (PVA) particles. MATERIALS AND METHODS: Charts and radiographs were reviewed of 35 patients undergoing 63 separate sessions of embolotherapy between January 1993 and July 1997. Patient demographics, tumor type, indication for embolization, and complications were recorded. Symptomatic and morphologic responses to therapy were noted, as well as duration of response. RESULTS: Fourteen men and 21 women underwent embolization of 21 carcinoid and 14 islet cell tumors metastatic to the liver. These patients underwent 63 separate episodes of embolotherapy. Of 48 episodes that could be evaluated, response to treatment was noted following 46 episodes (96%). The duration of response was longest in patients treated for hormonal symptoms with (17.5 months) or without (16 months) pain, and was shortest (6.2 months) when the indication was pain alone. Complications occurred after 11 of the 63 embolizations (17%), including four (6%) deaths. Cumulative 5-year survival following embolotherapy was 54%. CONCLUSION: Hepatic artery embolization with PVA particles is beneficial for patients with neuroendocrine tumors metastatic to the liver and may be used for control of pain as well as hormonal symptoms. This therapy should be used cautiously when more than 75% of the hepatic parenchyma is replaced by tumor.     

甲状腺机能亢进的介入治疗

目的：探讨动脉内栓塞治疗甲状腺机能亢进 （甲亢）的临床应用。方法：对11例甲亢患者作甲状腺上动脉及下动脉的超选择性插管，并对上述血管行栓塞术。结果：11例甲状腺动脉栓塞均成功，栓塞后10例患者甲状腺机能逐渐恢复至正常水平，1例患者症状未得到满意控制，第2次行右侧甲状腺下动脉栓塞术后甲状腺机能逐渐恢复至正常水平，全部病例术后均无严重并发症发生。结论：动脉内栓塞治疗甲亢安全、简便、痛苦小、并发症少，是十分有效的治疗方法。     

Embolization of high flow arteriovenous malformations: experience with use of superabsorbent polymer microspheres

PURPOSE: To determine efficacy, safety, and requirements for adjunctive embolization or surgery in the treatment of symptomatic arteriovenous malformations (AVMs) with superabsorbent polymer microsphere (SAP-MS) particles. MATERIALS AND METHODS: SAP-MS particles (sodium acrylate and vinyl alcohol copolymer) are nonbiodegradable spheres with a precisely calibrated diameter. SAP-MS particles swell by absorbing fluids and become soft and deformable. Twenty-five patients (16 men, nine women; mean age, 32 y; range 12-66 y) with symptomatic facial (n = 5), upper- (n = 8) and lower- (n = 12) extremity AVMs were treated primarily (n = 23) or preoperatively (n = 2) by transarterial embolization (TAE) treatment with use of SAP-MS particles. Direct puncture embolization (DPE; n = 4) and/or surgical intervention (n = 5; ie, skin graft, resection, or amputation) were required. Surgical specimens from the resected (n = 2) and the amputated (n = 2) patients were evaluated histologically. Follow-up study, including clinical findings and imaging studies, was performed at intervals ranging from 3 months to 1 year. Clinical outcome was evaluated retrospectively, depending on the subjective improvement of symptoms and signs, according to the medical records. RESULTS: Seventy-two TAEs (range, 1-11; mean, 2.8) and 12 DPEs (range, 1-3; mean, 2.4) were performed during the mean follow-up period of 38 months (range, 7-110 mo). Twenty patients (80%) experienced symptom improvement by embolotherapy alone (n = 17) or in combination with surgery (n = 3). One lip and two finger AVMs were totally removed by surgical excision or amputation after TAE treatment. In diffuse upper- (n = 1) and lower- (n = 1) extremity AVMs, the symptoms were uncontrolled. No nerve injury or skin necrosis was observed after TAE treatment with SAP-MS particles. Mucosal necrosis was induced by DPE with ethanol in one patient. Histologically, SAP-MS particles penetrated intralesional vessels and conformed to the vessel lumen, resulting in tight vessel occlusion. Minimal perivascular reaction was observed. CONCLUSION: SAP-MS particles were used safely in TAE treatment of AVM. TAE treatment with use of SAP-MS particles was suitable for certain symptomatic AVMs, but diffuse AVMs remain a challenge and a combination of alternative methods will be necessary for further strategy.     

Transcatheter Microcoil Embolotherapy for Ruptured Pseudoaneurysm Following Pancreatic and Biliary Surgery

Purpose: To evaluate the outcome of transcatheter microcoil embolotherapy for bleeding pseudoaneurysms complicating major pancreatic and biliary surgery. Materials and Methods: Over an 8-year period, 8 patients were encountered who developed massive bleeding from pseudoaneurysms 15–64 days (mean 31 days) following major pancreatic and biliary surgery. Urgent transcatheter microcoil embolotherapy was performed in all 8 patients. Results: Transcatheter embolotherapy was successful in 7 of 8 patients (88%) but failed in one due to development of disseminated intravascular coagulation. One patient developed recurrent bleeding 36 days after the first embolotherapy from a newly developed pseudoaneurysm, which was again treated successfully with embolization. Two patients subsequently underwent additional surgery for residual pathology. Three of the 7 patients with successful embolotherapy were alive at 10–96 months, 4 patients died of associated malignancies 4–20 months after embolotherapy. Conclusion: Transcatheter microcoil embolotherapy is effective for bleeding pseudoaneurysms complicating pancreatic and biliary surgery, and should be considered the first treatment of choice.     

经导管肾动脉节段性栓塞治疗肾动静脉畸形

目的：探讨经导管肾动脉节段性栓塞治疗肾动静脉畸形的栓塞材料及其效果。方法：9例因肾动静脉畸形（先天性者8例，获得性者1例）引起大量血尿患者，施行经导管肾动脉节段性栓塞治疗10次，栓塞材料为无水乙醇、聚乙烯醇颗粒、异丁基-2-氰基丙烯酸酯和弹簧圈。9例患者术后随访观察10-56个月。结果：9例患者栓塞术后肾动脉造影显示畸形血管完全闭塞，3d内血尿消失。随访期间，9例患者中，只有1例单纯应用弹簧圈栓塞患者术后6个月血尿复发，血管造影证实为侧支血管形成导致畸形血管再通，改行无水乙醇及弹簧圈栓塞，术后18个月血尿未再复发。9例患者均无严重并发症发生。结论：经导管肾动脉节段性栓塞是治疗肾动静脉畸形的安全有效的方法，栓塞材料以无水乙醇和弹簧 圈联合栓塞为最佳。     

Can Induction of Systemic Hypotension Help Prevent Nidus Rupture Complicating Arteriovenous Malformation Embolization?: Analysis of Underlying Mechanisms Achieved Using a Theoretical Model

BACKGROUND AND PURPOSE: Nidus rupture is a serious complication of intracranial arteriovenous malformation (AVM) embolotherapy, but its pathogenetic mechanisms are not well described. An AVM model based on electrical network analysis was used to investigate theoretically the potential role of hemodynamic perturbations for elevating the risk of nidus vessel rupture (Rrupt) after simulated AVM embolotherapy, and to assess the potential benefit of systemic hypotension for preventing rupture. METHODS: Five separate hypothetical mechanisms for nidus hemorrhage were studied: 1) intranidal rerouting of blood pressure; 2) extranidal rerouting of blood pressure; 3) occlusion of draining veins with glue; 4) delayed thrombosis of draining veins; and 5) excessively high injection pressures proximal to the nidus. Simulated occlusion of vessels or elevated injection pressures were implemented into the AVM model, and electrical circuit analysis revealed the consequent changes in intranidal flow, pressure, and Rrupt for the nidus vessels. An expression for Rrupt was derived based on the functional distribution of the critical radii of component vessels. If AVM rupture was observed (Rrupt > or = 100%) at systemic normotension (mean pressure [P] = 74 mm Hg), the theoretical embolization was repeated under systemic hypotension (minor P = 70 mm Hg, moderate P = 50 mm Hg, or profound P = 25 mm Hg) to assess the potential benefit of this maneuver in reducing hemorrhage rates. RESULTS: All five pathogenetic mechanisms under investigation were able to produce rupture of AVMs during or after embolotherapy. These different mechanisms had in common the capability of generating surges in intranidal hemodynamic parameters resulting in nidus vessel rupture. The theoretical induction of systemic hypotension during and after treatment was shown to be of significant benefit in attenuating these surges and reducing Rrupt to safer levels below 100%. CONCLUSION: The induction of systemic hypotension during and after AVM embolization would appear theoretically to be of potential use in preventing iatrogenic nidus hemorrhage. The described AVM model should serve as a useful research tool for further theoretical investigations of AVM embolotherapy and its hemodynamic sequelae.     

头面部复杂动静脉畸形的栓塞治疗

目的　研究经导管栓塞技术在头面部动静脉畸形治疗中的应用。方法　 3 0例头面部动静脉畸形患者共接受 40次栓塞治疗。其中使用国产TH胶栓塞者为 18例 2 0次 ,使用进口PVA微粒栓塞者为 12例 2 0次。结果　 3 0例患者均成功实行瘤灶供血动脉栓塞术。所有患者栓塞术后临床症状明显改善 ,如瘤体缩小甚至消失 ,皮温降低 ,搏动感和血管杂音减弱或消失等。术后随访3～ 6个月 ,12例复发。全部病例均无严重并发症。结论　对于头面部动静脉畸形的患者来说 ,经导管栓塞术是一种较好的非手术治疗方法 ,在栓塞剂的选择方面 ,则以PVA微粒栓塞更为理想。     

动脉栓塞治疗男性先天性盆腔动静脉畸形一例

报道1例长期原因不明肉眼血尿多囊肾患者。影像检查显示两侧盆区动静脉畸形(CPAVM)。经超选择栓塞髂内动脉8支分支血尿治愈,随访6个月,血尿无复发。文献复习表明CPAVM发病甚少,形态多样。介入治疗是有效的微创方法。     

The positive predictive value of mammography.

OBJECTIVE. The major risk of transcatheter embolotherapy for acute hemorrhage in the lower gastrointestinal tract is irreversible intestinal ischemia. The authors studied the efficacy and safety of superselective transcatheter embolization with polyvinyl alcohol particles in arresting acute hemorrhage in the lower gastrointestinal tract. SUBJECTS AND METHODS. All patients with clinical or scintigraphic evidence of acute hemorrhage in the lower gastrointestinal tract were considered for superselective embolization. The nine patients with angiograms that showed active hemorrhage in the lower gastrointestinal tract underwent the procedure. Superselective embolization was done through a 3-French catheter and was accomplished by using 100- to 590-microns polyvinyl alcohol particles. The segments of the intestinal tracts involved in the embolizations were examined for the presence of ischemia by endoscopy (n = 7) or histologic evaluation of a surgical specimen (n = 2) 2-44 days (mean, 11 days) after embolization or by clinical evaluation (n = 1). RESULTS. The lesions treated by this method were located in the colon (n = 8) and jejunum (n = 1). Immediate hemostasis was achieved in every case. Three patients had recurrent lower gastrointestinal hemorrhage 1-24 days (mean, 9 days) after initial embolization. Two of these patients had surgery, while one had a successful second embolization. Two asymptomatic patients were found endoscopically to have small areas of ischemia involving only the mucosa. Only one patient was shown to have severe mucosal ischemia; this involved the colon in a distribution that suggested it was not caused by the embolization. CONCLUSION. Ten superselective embolization procedures that used polyvinyl alcohol particles successfully controlled hemorrhage in the lower gastrointestinal tract in nine patients. In no case was intestinal infarction induced by the procedure, and only two endoscopically proved cases of asymptomatic mucosal ischemia occurred.     

髓内血管畸形的血管构筑学及栓塞治疗

目的：探讨髓内动静脉畸形（AVM）的血管构型、血管内栓塞的指征及栓塞治疗的效果。方法：15例患者均有不同程度的肢体瘫痪、感觉障碍、括约肌功能障碍行DSA检查和栓塞治疗。栓塞材料选用PVA颗粒及丝线段。结果：15例中,球型3例,幼稚型12例;球型AVM均为单支动脉供血;幼稚型AVM为多支动脉供血,其中7例为2支供血动脉,5例有3支以上供血动脉,2例伴有动静脉瘘（AVF）;15例患者经27例次栓塞治疗,根据栓塞前后脊髓功能评价,痊愈2例,显效3例,好转6例,4例无变化,无1例加重。经6个月－5年随访,症状较栓塞前改善者4例;栓塞后症状维持者2例;栓塞后症状再次反复者7例,再次行栓塞治疗;失得2例。结论：髓内AVM应栓塞畸形血管团,减轻静脉压力,减少出血机会;血管内栓塞治疗脊髓血管畸形是一种创伤小、安全性高、有效的治疗方法。     

颈静脉球瘤的栓塞治疗

目的:评价介入栓塞治疗对颈静脉球瘤的作用.方法:3 例颈静脉球瘤患者,采用Seldinger技术行超选择性插管造影明确病变部位及其供血动脉,然后灌注聚乙烯醇颗粒(PVA颗粒)适量.结果:3例患者肿瘤供血动脉均被栓塞,肿瘤染色消失;2例栓塞后1周行手术切除,均完全切除且出血量少.栓塞后随访观察,患者的临床症状均减轻或消失.结论:颈静脉球瘤的栓塞治疗对于减少术中出血和抑制肿瘤生长有积极的作用,术前栓塞加外科手术切除是治疗颈静脉球瘤的一种安全有效的方法.     

Rat Model of Hindlimb Ischemia Induced via Embolization with Polyvinyl Alcohol and N-Butyl Cyanoacrylate

Objective

To investigate the feasibility of a rat model on hindlimb ischemia induced by embolization from the administration of polyvinyl alcohol (PVA) particles or N-butyl cyanoacrylate (NBCA).

Materials and Methods

Unilateral hindlimb ischemia was induced by embolization with NBCA (n = 4), PVA (n = 4) or surgical excision (n = 4) in a total of 12 Sprague-Dawley rats. On days 0, 7 and 14, the time-of-flight magnetic resonance angiography (TOF-MRA) and enhanced MRI were obtained as scheduled by using a 3T-MR scanner. The clinical ischemic index, volume change and degree of muscle necrosis observed on the enhanced MRI in the ischemic hindlimb were being compared among three groups using the analysis of variance. Vascular patency on TOF-MRA was evaluated and correlated with angiographic findings when using an inter-rater agreement test.

Results

There was a technical success rate of 100% for both the embolization and surgery groups. The clinical ischemic index did not significantly differ. On day 7, the ratios of the muscular infarctions were 0.436, 0.173 and 0 at thigh levels and 0.503, 0.337 and 0 at calf levels for the NBCA, PVA and surgery groups, respectively. In addition, the embolization group presented increased volume and then decreased volume on days 7 and 14, respectively. The surgery group presented a gradual volume decrease. Good correlation was shown between the TOF-MRA and angiographic findings (kappa value of 0.795).

Conclusion

The examined hindlimb ischemia model using embolization with NBCA and PVA particles in rats is a feasible model for further research, and muscle necrosis was evident as compared with the surgical model.     

肾段及亚段疾病血管栓塞术的临床应用

目的：探讨经肾动脉手管超选择至肾段及肾亚段对肾肿瘤及肾动静脉畸形进行栓塞治疗的临床应用价值。方法：4例肾肿瘤患，经导管超选择至肾段及肾亚段，行化疗栓塞术。8例肾动静脉畸形均经DSA证实，经导管超选择性插管至肾段及肾亚段行栓塞治疗。栓塞材料为弹簧图、无水酒精、PVA或IBCA。结果：4例肾肿瘤患节段性栓塞均获得成功，治疗后肿瘤缩小，碘油沉积良好，CT复查肿瘤平均6个月无复发，相邻的肾段无梗死征象。8例肾动静脉畸形患超选择性栓塞均获得成功。1例术后6个月血尿复发，再次栓塞后血尿症状消失，其余未见复发。结论：肾段及肾亚段栓塞是治疗无手术适应证的肾脏肿瘤及肾动静脉畸形的有效方法，互能够最大限度的保护正常肾脏，并发症少。