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首页> 外文期刊>Acta Radiologica >Epistaxis in patients with hereditary hemorrhagic telangiectasia treated with selective arterial embolization.
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Epistaxis in patients with hereditary hemorrhagic telangiectasia treated with selective arterial embolization.

机译：选择性动脉栓塞治疗的遗传性出血性毛细血管扩张患者的鼻出血。

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BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare systemic fibrovascular dysplasia also known as Rendu-Osler-Weber disease. Epistaxis is often the first and foremost symptom of the disease and recurrent epistaxis is the main complaint. PURPOSE: Evaluation of effectiveness and safety of endovascular treatment of epistaxis in HHT patients. MATERIAL AND METHODS: Between June 2004 and January 2008, 14 patients with HHT underwent embolization of external carotid artery (ECA) branches due to severe epistaxis. There were eight men and six women aged 27-42 years. Patients were referred for endovascular treatment when primary management with electrocautery and nasal packing was ineffective. Arteries suspected of bleeding were catheterized super-selectively with micro-catheters to perform embolization. Polyvinyl alcohol particles (PVA) or embospheres in diameter of 500-700-microm were used as an embolic material. RESULTS: Embolization was technically successful in 11 (78.5%) patients. Immediate, complete control of bleeding was achieved in 12 (85%) patients. During long-term follow-up recurrent nasal bleeding occurred in six (43%) patients 6-24 months after treatment. There were no severe complications after embolization. Nine patients experienced mild facial pain which resolved within three days after the treatment. Three patients in whom arterial spasm was observed, suffered from facial paraesthesia lasting for 3-5 days after embolization. Out of 14 patients, 12 were available for 24-month follow-up evaluation. All except one claimed reduction in frequency and severity of epistaxis which had a positive impact on their quality of life. CONCLUSION: Endovascular embolization of epistaxis in patients with HHT is an effective and safe procedure although it cannot provide a long-term cure in most cases. Embolization reduces the frequency, severity and duration of nasal bleeding in patients with HHT, improving patients' quality of life.
机译：背景：遗传性出血性毛细血管扩张症（HHT）是一种罕见的系统性纤维血管发育不良，也称为Rendu-Osler-Weber病。鼻出血通常是该疾病的首要症状，而复发性鼻出血是主要症状。目的：评价HHT患者鼻内血管治疗的有效性和安全性。材料与方法：2004年6月至2008年1月，由于严重的鼻axis，有14例HHT患者接受了颈外动脉（ECA）分支的栓塞治疗。年龄在27-42岁之间的有八男六女。当电灼和鼻腔填充的主要治疗无效时，将患者转诊至血管内治疗。将怀疑出血的动脉用微导管超选择性地插入导管以进行栓塞。直径为500-700微米的聚乙烯醇颗粒（PVA）或栓塞用作栓塞材料。结果：11例（78.5％）患者栓塞技术成功。立即（12％）患者（85％）完全控制了出血。在长期随访期间，治疗后6-24个月有6例（43％）患者复发鼻出血。栓塞后无严重并发症。九名患者经历了轻度的面部疼痛，在治疗后三天内缓解了。观察到动脉痉挛的三名患者在栓塞后持续3-5天出现面部感觉异常。在14位患者中，有12位可以进行24个月的随访评估。除了一个人，所有人都声称减少了鼻epi的发生频率和严重程度，这对其生活质量产生了积极影响。结论：HHT患者鼻内栓塞术是一种有效且安全的方法，尽管在大多数情况下不能长期治愈。栓塞术可降低HHT患者鼻腔出血的频率，严重程度和持续时间，从而改善患者的生活质量。

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