Clinical value of the assistant interventional embolization in treatment of juvenile nasopharyngeal angiofibroma

Objective To study the application of the assistant digital subtraction angiography(DSA) with selective intra-arterial embolization in comprehensive treatment of juvenile nasopharyngeal angiofibroma. Methods Among 17 patients with juvenile nasopharyngeal angiofibroma confirmed by surgery and biopsy from February 2000 to June 2005,13 cases underwent DSA examination and selective intra-arterial embolization on 1～4 days before surgical operation,and 4 cases with uncontrollable epistaxis through conventional therapy were carried out urgent DSA and embolization as well as surgical operation on a scheduled day.Angiographic manifestations and hemostatic effects and impacts in surgical operation were observed.Results The extent and blood supply of lesions and the features of feeding artery were clearly demonstrated by DSA.Supplying vessel was mainly maxillary artery originating from external caroted artery in 16 cases,and double supplying vessels from ramus of internal and external carotid arteries in 1 case.In general,the higher the nasopharyngeal angiofibroma grade was the more supplying branches would exist.As for epistaxis patients,the number of the presence of irregular distal vessels and the punctiform extravasation of contrast media were displayed in positive proportion,No severe complications occurred and active bleeding was stopped after embolization and furthermore with less blood loss during surgical operation statistically about 280～1600ml(460±255.5). Conclusions DSA examination and selective arterial embolization can not only present more accurate important clinical imaging features but also in favour of stop bleeding and enhance surgical outcomes for patients with nasopharyngeal angiogibroma.(J Intervent Radiol,2007,16:88-91)