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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Evolving experience with direct puncture therapeutic embolization for adjunctive and palliative management of head and neck hypervascular neoplasms.
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Evolving experience with direct puncture therapeutic embolization for adjunctive and palliative management of head and neck hypervascular neoplasms.

机译：直接穿刺治疗栓塞治疗头颈部高血管肿瘤的辅助和姑息治疗的不断发展的经验。

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OBJECTIVES: The use of percutaneous, direct puncture therapeutic embolization (DPTE) of hypervascular head and neck neoplasms is a relatively new modality that may be used to supplement or supplant conventional endovascular transarterial embolization. Although the preliminary clinical experience reported by a single group has been favorable, extensive case series experience is lacking. This prompted us to review our recent clinical experience with these techniques to determine safety, efficacy, and emerging role in the overall neurointerventional therapeutic armamentarium. STUDY DESIGN: A retrospective analysis of the previous 34 consecutive cases of hypervascular tumors undergoing DPTE referred to our service for therapeutic devascularization was performed. METHODS: Complete case record review was undertaken. Twenty-six of 34 cases involved DPTE of head and neck neoplasms. Conventional diagnostic angiography was performed for therapeutic planning and to assist in precise localization. When performed, standard microcatheter transarterial embolization techniques were used either before or after attempted DPTE. Cyanoacrylate embolic mixtures (n-butyl cyanoacrylate [NBCA], lipiodol, powdered tungsten) were used in 21 of 24 cases, and absolute ethanol in 3 of 24. Direct puncture angiography of the targeted tumor neovasculature was always performed before DPTE. RESULTS: Twenty-four of 26 cases had technically successful DPTE. Combined transarterial embolization with DPTE was used in 16 of 24 cases, although for the last 12 cases, 9 were treated predominantly or exclusively by DPTE. There were no major or minor clinical complications, and there was one asymptomatic technical complication. Total or near-total devascularization was achieved in all cases. All preoperative cases had excellent hemostasis within the resected tumor bed. CONCLUSIONS: Our results lend further support to the safety and efficacy of DPTE in the management of hypervascular neoplasms of the head and neck. With our increasing experience, this technique is evolving into a primary therapeutic modality for optimal tumor devascularization.
机译：目的：对超血管头颈部肿瘤进行经皮直接穿刺治疗栓塞术（DPTE）是一种相对较新的方法，可用于补充或取代常规的血管内动脉栓塞术。尽管单个小组报告的初步临床经验是令人满意的，但缺乏丰富的病例系列经验。这促使我们回顾了我们最近使用这些技术的临床经验，以确定安全性，疗效以及在整个神经介入治疗武器库中的新兴作用。研究设计：回顾性分析了先前连续34例接受DPTE的高血管肿瘤病例，这些病例被称为我们的治疗性血运重建服务。方法：进行了完整的病例记录审查。 34例中有26例涉及头颈部肿瘤的DPTE。进行常规诊断性血管造影以进行治疗计划并协助精确定位。进行DPTE之前或之后，应使用标准的微导管经动脉栓塞技术。 24例中有21例使用了氰基丙烯酸酯栓塞剂混合物（氰基丙烯酸正丁酯[NBCA]，碘油，钨粉），而24例中有3例使用了无水乙醇。在进行DPTE之前，始终要对目标肿瘤新脉管系统进行直接穿刺血管造影。结果：26例中有24例在技术上获得了成功的DPTE。 24例中有16例采用了经动脉栓塞与DPTE联合治疗，尽管在最后12例中，有9例主要或完全由DPTE治疗。没有重大的或次要的临床并发症，并且有一个无症状的技术并发症。在所有情况下都实现了完全或几乎完全的血运重建。所有术前病例在切除的肿瘤床上均具有出色的止血效果。结论：我们的研究结果进一步支持了DPTE在治疗头颈部高血管肿瘤中的安全性和有效性。随着我们不断积累的经验，该技术正在发展成为一种最佳的肿瘤血运重建术。

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