应用数字减影血管造影诊治颅内假性动脉瘤

数字减影血管造影（DigitalSubtractionAn－giography，DSA）因具有图像清晰，诊断迅速，准确性高，效果满意等优点，而逐渐应用于各种血管疾病的诊断和栓塞治疗。近年，我们应用DSA诊治2例因外伤后引起颅内假性动脉瘤致反复大量鼻出血患者，效果满意。现报告如下。1材料与方法1．1临床资料2例患者，男女各1例，年龄为27岁、46岁。均有明确的外伤史。外伤后有反复间歇性鼻腔大出血，经鼻腔填塞后出血暂时能止住，抽除纱条后一段时间又发生大出血。每次出血量为100～200ml。1例伴左眼视力逐渐下降至光感并伴头痛。实验室检查，鼻腔、鼻窦…     

颈内动脉虹吸段完全性栓塞治疗创伤性假性动脉瘤

目的：通过数字减影血管造影（digital subtraction angiography,DSA)技术诊断颅脑外伤所致的颈内动脉（internal carotid artery,ICA)虹吸段假性动脉瘤。方法：对颅脑外伤合并严重鼻出血的患者进行DSA造影，筛选出虹吸段ICA假性动脉瘤6例，经脑动脉环侧支循环功能检测，对功能良好者进行ICA虹吸段完全性栓塞。结果：6例经DSA明确诊断为ICA假性动脉瘤，5例进行了动脉栓塞，其中4例痊愈，1例死亡；另1例脑动脉环侧支循环功能不良，未行栓塞，行改善侧支循环功能训练时鼻出血死亡。结论：经DSA明确诊断的颈内动脉假性动脉瘤，经脑动脉环侧支循环筛选后，可行虹吸段颈内动脉完全性栓塞治疗。     

鼻出血血管造影栓塞治疗的护理

鼻出血是耳鼻咽喉科常见病，也是急重症之一。多数学者主张，如果手术治疗失败，就需进行以血管造影方法栓塞供应鼻腔血源的末梢血管。随着血管造影技术的改进和被广泛应用，此法被积极用于治疗鼻出血患者，其地位与手术治疗并列，且有效率高于手术治疗。此法可以直接看到出血部位及其邻近的血管，因此可以尽量靠近末梢处栓塞血管，避免来自侧支循环所致的再次出血，减轻患者痛苦。     

Arterial embolization in malignant neoformations of the face and neck]

On the basis of 25 cases of embolisation for cervico-facial tumours, it was possible to demonstrate the value of this technique in the treatment of local haemorrhage and in the relief of pain in patients with a lesion beyond hope of any treatment.     

Arterial embolization for control of bleeding in advanced head and neck carcinoma

There are a number of patients with unresectable recurrent carcinoma of the head and neck who continue to lead a relatively functional life despite advanced local disease. For these patients bleeding from tumor represents a devastating complication that can abruptly terminate the course of an otherwise chronic disease, albeit a uniformly fatal one. The technique we describe renders a relatively safe and effective treatment that seems to control this problem. We report on our experience with three patients whose tumor bleeding was controlled by permanent intra-arterial embolization with Ivalon, a polyvinyl alcohol-based foam. The technique, indications, and complications are discussed.     

Endovascular embolization of a traumatic arteriovenous fistula of the superficial temporal artery

Arteriovenous fistula of the superficial temporal artery is a rare condition most commonly caused by trauma. Traditional surgical treatment has been superseded by endovascular embolization. We present the case of a 40 year-old man with a traumatic arteriovenous fistula of the superficial temporal artery who was treated by endovascular embolization. The advantages of this approach are discussed, along with a brief history of the condition.     

Selective embolization in the treatment of intractable epistaxis

Conclusions. In skilled hands, selective embolization is a safe procedure and represents an effective treatment for prolonged epistaxis. Embolization therapy can be repeated if necessary. Objective. Severe posterior epistaxis is a common clinical problem in an ENT department and controlling the bleeding may present difficulties. Several methods are used to control posterior epistaxis, one of the latest treatment strategies being selective embolization of the nasal arteries. The aim of this study was to describe the effect of selective embolization in 22 patients treated with a total of 30 procedures at the ENT Department of Odense University Hospital between January 1995 and March 2004. To our knowledge this is the first Nordic work in which selective embolization has been used as a treatment strategy for patients with hereditary hemorrhagic telangiectasia (HHT). Material and methods. This was a retrospective review. Post-treatment effects and complications were evaluated by means of a questionnaire and a telephone interview. Owing to the different treatment strategies used, the results were evaluated for 2 groups of patients: Group A, 9 patients with HHT; and Group B, 13 patients with causes of epistaxis other than HHT. Results. In Group A, 15 procedures were performed, 12 of which were beneficial as the duration and number of episodes of epistaxis were reduced. In Group B, 15 procedures were performed and the success rate was 87%. One patient suffered from skin necrosis at the tip of the nose. No other serious side-effects of the treatment were observed.     

Selective embolization in the treatment of intractable epistaxis

CONCLUSIONS: In skilled hands, selective embolization is a safe procedure and represents an effective treatment for prolonged epistaxis. Embolization therapy can be repeated if necessary. OBJECTIVE: Severe posterior epistaxis is a common clinical problem in an ENT department and controlling the bleeding may present difficulties. Several methods are used to control posterior epistaxis, one of the latest treatment strategies being selective embolization of the nasal arteries. The aim of this study was to describe the effect of selective embolization in 22 patients treated with a total of 30 procedures at the ENT Department of Odense University Hospital between January 1995 and March 2004. To our knowledge this is the first Nordic work in which selective embolization has been used as a treatment strategy for patients with hereditary hemorrhagic telangiectasia (HHT). MATERIAL AND METHODS: This was a retrospective review. Post-treatment effects and complications were evaluated by means of a questionnaire and a telephone interview. Owing to the different treatment strategies used, the results were evaluated for 2 groups of patients: Group A, 9 patients with HHT; and Group B, 13 patients with causes of epistaxis other than HHT. RESULTS: In Group A, 15 procedures were performed, 12 of which were beneficial as the duration and number of episodes of epistaxis were reduced. In Group B, 15 procedures were performed and the success rate was 87%. One patient suffered from skin necrosis at the tip of the nose. No other serious side-effects of the treatment were observed.     

Place of embolization in the treatment of severe epistaxis

On the basis of long-term study on embolization for severe epistaxis, the authors show the different indications and results of this relatively new method; and 54 cases are presented including Rendu-Osler diseases, primary and traumatic epistaxis, or those due to vascular malformation and benign or malignant tumors. Embolization can prove a very effective method in most cases.