Double Microballoon-occluded Ethanol Embolization for Pelvic Arteriovenous Malformation: A Case Report.

Keigo Osuga, Naoki Yokota, Kazuhiro Yamamoto, Hiroki Matsutani, Kiyohito Yamamoto, Hiroshi Juri, Hideki Ozawa, Takahiro Katsumata
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Abstract

A 40-year-old man was incidentally found to have right-sided pelvic arteriovenous malformation (AVM) with an aneurysmal dominant outflow vein (DOV). The AVM had two main feeding arteries forming a cluster of fine vessels shunt to the DOV. As transvenous approach was impossible due to anatomical difficulty, transarterial ethanol embolization was performed under simultaneous double microballoon occlusion of the two feeding arteries in combination with protective coil embolization of the prostatic branches. Ethanol (13 mL) was intermittently injected from both microballoon catheters until the AV shunt was completely occluded. At 1-year follow-up, contrast-enhanced CT revealed shrinkage of the thrombosed DOV without any symptom. Our case demonstrated the usefulness of simultaneous double microballoon-occluded ethanol embolization for treating a localized pelvic AVM with a few feeding arteries.

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盆腔动静脉畸形的双微球闭塞乙醇栓塞术:病例报告。
一名 40 岁的男子被偶然发现患有右侧盆腔动静脉畸形(AVM),并伴有动脉瘤状显性流出静脉(DOV)。该动静脉畸形有两条主要进血动脉,形成一簇分流至 DOV 的细血管。由于解剖上的困难,经静脉入路是不可能的,因此在同时对两条供血动脉进行双微球闭塞的情况下,结合前列腺分支的保护性线圈栓塞,进行了经动脉乙醇栓塞。乙醇(13 毫升)从两个微球导管中间歇注入,直至房室分流完全闭塞。随访一年后,对比增强 CT 显示血栓形成的 DOV 缩小,但没有任何症状。我们的病例证明了同时使用双微球导管乙醇栓塞术治疗有少量供血动脉的局部盆腔动静脉畸形的有效性。
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