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I.はじめに
顔面に発生した動静脈奇形(facial arteriovenousmalformations:FAVM)は,外頸動脈からの豊富なvascular networkが存在するため,feederocclusionのみでは早期にcollateral networkが増生し根治は期待できない.したがって,nidusそのものを閉塞する必要があり,この目的で液体塞栓物質が用いられることが多い.しかしながら,液体塞栓物質を用いると皮膚壊死や脳神経麻痺の合併症の危険性があり,cosmeticな問題を解決するという本来の治療目的には反している.
われわれは,FAVMの治療において適切な粒子塞栓物質を用いることで,従来報告されていた再開通の問題がなく良好な治療結果を得ることができた.本疾患における粒子塞栓物質を用いた治療法について検討を加え報告する.
Facial arteriovenous malformations (FAVM) are difficult to treat because of their highly vascular net-works. Intravascular treatment using liquid material to occlude the FAVM occasionally results in skin nec-rosis after embolization. The use of particulate materials to obliterate the nidus often fails to obtain apermanent cure due to arterial recanalization.
We report two patients with FAVM who were successfully treated with endovascular embolization usinga new type of particulate material. One patient was treated with embolization only, the other was treatedwith embolization followed by surgical resection. Both patients showed clinical and angiographic improve-ment.
Intravascular treatment using particles with a smooth surface and optimal size is safe and effective in thetreatment of patients with FAVM.
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