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。

Transarterial embolization of congenital pelvic arteriovenous malformation in a male (A case report and review of the literature)

A case of congenital pelvic arteriovenous malformation in a 41-years-old male treated by successful transarterial embolization was reported.This patient suffered from adult polycystic kidney disease and unknown reason for gross hematuria for four years.His left kidney was resected one year ago for suspected left nephrorrhagia but the hematuria remained.MRI examination of pelvis demonstrated AVM involving extensively the pelvic soft tissue,bladder and seminal vesicles.Bilateral internal iliac arterial angiography by DSA showed congenital pelvic arteriovenous malformations(CPAVM),the fringy anisotrophy vascular plexus supplied by many feeding arteries and drained into bilateral dilated and tortuous internal iliac venous branches.Super-selective catheterization and embolization for eight supplying blood branches,such as bilateral internal pudendal arterial branches,right obturator arterial branches,right inferior gluteal arterial branches,left superior vesical artery,left inferior vesical artery,spermatocyst artery and right lateral sacral artery etc,were carried out successfully with gelfoam sponge or PVA particulates in one time.His urine turned clear on the same day after arterial embolization,and no gross hematuria occurred during 6-months follow-up.The pelvic arterial angiography with embolization is extremely effective for the diagnostic and therapeutic measure of CPAVM.