Systemic Hemodynamic Changes in Low-Dose Ethanol Embolotherapy for Soft-Tissue Arteriovenous Malformations

作     者：Xi YANG Chen HUA Hui CHEN Lan LUO Gang MA Xiaojie HU YaJing QIU Wenxin YU Lei CHANG Yunbo JIN Xiaoxi LIN Xi YANG;Chen HUA;Hui CHEN;Lan LUO;Gang MA;Xiaojie HU;YaJing QIU;Wenxin YU;Lei CHANG;Yunbo JIN;Xiaoxi LIN

作者机构：Department of Plastic SurgeryShanghai Ninth People’s HospitalShanghai Jiaotong University School of MedicineShanghai 200011China 

出 版 物：《Chinese Journal of Plastic and Reconstructive Surgery》 (Chinese Journal of Plastic and Reconstructive Surgery)

年 卷 期：2021年第3卷第1期

页      面：32-40页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Systemic hemodynamic change Ethanol embolotherapy Arteriovenous malformations Hypotension Blood pressure Heart rate 

摘      要：Background Ethanol embolotherapy is considered an optimal choice for the treatment of arteriovenous malformations(AVMs);however,there are some complications associated with this *** study aimed to prospectively investigate systemic hemodynamic changes in high-flow AVMs using ethanol *** From September 2012 to September 2014,34 male patients and 26 female patients with AVMs who underwent embolotherapy(100 sessions in total)with absolute ethanol were included in this *** systolic blood pressure(SBP)and heart rate(HR)were recorded before and after each injection and throughout the *** between the initial and highest SBP(ΔmaxSP)and HR values(ΔmaxHR),as well as the initial and final SBP(ΔSP)and HR(ΔHR)values,were *** aimed to explore the potential association between these values and the amount of ethanol that was *** The total ethanol used was variable(0.01–0.40 mL/kg;mean,0.20 mL/kg).SBP and HR increased after ethanol injection in most sessions(91 in 100 sessions).SBP decreased in 9 sessions(9 in 100 sessions),while HR,oxygen saturation,and end-tidal CO2 decreased in one of the 9 sessions.ΔmaxSP andΔmaxHR averaged 38.4 mmHg and 27.8 bpm,respectively(both P0.05),whileΔSP andΔHR averaged 3.4 mmHg and 4.0 bpm,respectively(both P0.05).ΔmaxSP andΔmaxHR were positively correlated with the total dose of ethanol *** Elevations in SBP and HR during ethanol embolotherapy are common,temporary,and most likely pain-mediated;these increases tend to be positively correlated with ethanol *** may be regarded as an acute complication of ethanol *** combined with bradycardia,oxygen desaturation,and decreased end-tidal CO2 may be a potential predictor of cardiovascular collapse.