[1]周 涛,周 兵,马修尧,等.分次栓塞治疗大型脑动静脉畸形的临床总结[J].介入放射学杂志,2014,(07):561-564.
 ZHOU Tao,ZHOU Bing,MA Xiu yao,et al.Fractionated embolization for the treatment of large cerebral arteriovenous malformation: clinical experience in 35 cases[J].journal interventional radiology,2014,(07):561-564.
点击复制

分次栓塞治疗大型脑动静脉畸形的临床总结()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年07期
页码:
561-564
栏目:
神经介入
出版日期:
2014-07-25

文章信息/Info

Title:
Fractionated embolization for the treatment of large cerebral arteriovenous malformation: clinical experience in 35 cases
作者:
周 涛周 兵马修尧杨 明 杨 华
Author(s):
ZHOU Tao ZHOU Bing MA Xiu yao YANG Ming YANG Hua.
Department of Interventional Radiology, General Hospital of the Chinese People’s Armed Police of Zhejiang Province, Jiaxing, Zhejiang Province 314000, China
关键词:
血管内治疗 脑动静脉畸形 分次栓塞
文献标志码:
A
摘要:
【摘要】 目的 分析大型脑动静脉畸形(AVM)的分次栓塞治疗方法和策略。方法 2005 年5月—2013年5月对35例大型脑AVM患者行血管内分次栓塞治疗。大型脑AVM主要位于额叶11例,顶叶8例,颞叶6例,枕叶4例,侧颞区2例,脑白质深部及基底节区4例。畸形血管团最长径为6 ~ 12 cm,平均 7.23 cm,均为多支供血,(2 ~ 5支)。浅静脉引流13例,深静脉引流9例,深浅静脉均引流17例;静脉出口狭窄3例,扩张6例。造影见右侧16例,左侧19例。结果 35例患者共分行91次手术、297次栓塞治疗,其中栓塞使用NBCA 107次,ONYX胶153次,福爱乐医用胶15次,联合治疗使用NBCA和ONYX胶9例,ONYX和联合福爱乐医用胶13例,治疗后无死亡病例,大型AVM患者第1次栓塞后,剩余畸形团体积大多 < 50%,平均1 ~ 3个月后予以2次或多次栓塞治疗,最后完全栓塞者26例,大部栓塞(> 80%)者9例,术后恢复情况良好。经分次栓塞后,畸形血管团体积逐渐减少,最终达到临床治愈,或为显微神经外科手术切除或放射治疗奠定基础。结论 对于大型AVM进行血管内分次栓塞治疗效果肯定,值得临床推广应用。

参考文献/References:

[1] Weber W, Kis B, Siekmann R, et al. Endovascular treatment of intracranial arteriovenous malformations with onyx: technical aspects[J]. AJNR, 2007, 28: 371 ?蛳 377. [2] 石 潆, 赵 卫, 沈 进, 等. 脑动静脉畸形栓塞治疗术并发颅内出血的原因及处理[J]. 介入放射学杂志, 2012, 21: 185 ?蛳 189. [3] Miyasaka H, Yada K, Ohwada T, et al. Hemorrhagic venous infarction after excision of an AVMs[J]. Neurosurgery, 2009, 29: 265 ?蛳 268. [4] Hofmeister C, Stapf C, Hartmann A, et al. Demographic, morphological, and clinical characteristics of 1 289 patients with brain arteriovenous malformation[J]. Stroke, 2000, 31: 1307 ?蛳 1310. [5] Kaufmann TJ, Huston J 3rd, Mandrekar JN, et al. Complications of diagnostic cerebral angiography: evaluation of 19, 826 consecutive patients[J]. Radiology, 2007, 243: 812 ?蛳 819. [6] Stefani MA, Porter PJ, terbrugge KG, et al. Large and deep brain arteriovenous malformations are associated with risk of future hemorrhage[J]. Stroke, 2002, 33: 1220 ?蛳 1224. [7] Heidenreich JO, Hartlieb S, Stendel R, et al. Bleeding complications after endovascular therapy of cerebral arteriovenous malformations[J]. AJNR, 2006, 27: 313 ?蛳 316. [8] 沈 寻, 王志刚, 丁 璇, 等. ONYX液态栓塞剂在脑动静脉畸形栓塞术中的应用[J]. 山东医药, 2006, 46: 29 ?蛳 30. [9] Hu YC, Newman CB, Dashti SR, et al. Cranial dural arteriovenous fistula: transarterial Onyx embolization experience and technical nuances[J]. J Neurointerv Surg, 2011, 3: 5 ?蛳 13. [10] 喻 博, 高连波, 刘云会, 等. 应用Onyx液态栓塞剂治疗脑动静脉畸形的探讨[J]. 中华神经外科杂志, 2006, 22: 358 ?蛳 360. [11] 王 凡, 向贤宏, 杨 华, 等. 福爱乐医用胶栓塞治疗颅内动静脉畸形[J]. 中华神经医学杂志, 2012, 11: 734 ?蛳 736.

相似文献/References:

[1]杨志刚,刘建民,许奕,等.变异的原始三叉动脉夹层动脉瘤的血管内治疗一例并文献复习[J].介入放射学杂志,2008,(07):510.
 YANG Zhigang,LIU Jianmin,XU Yi,et al.Endovascular therapy of persistent trigeminal arterial variant dissection:A case report and literature review[J].journal interventional radiology,2008,(07):510.
[2]潘奇,刘建民,许奕,等.颈内动脉前壁动脉瘤支架结合弹簧圈栓塞术后再出血:病例报道[J].介入放射学杂志,2008,(08):560.
 PAN Qi,LIU Jianmin,XU Yi,et al.Rebleeding after stenting and coil embolization of an aneurysm in anterior wall of the internal carotid artery[J].journal interventional radiology,2008,(07):560.
[3]王武,李明华,顾斌贤.Willis覆膜支架治疗两侧外伤性颈内动脉海绵窦瘘一例[J].介入放射学杂志,2010,(04):300.
 WANG Wu,LI Minghua,GU Binxian.Endovascular treatment of bilateral traumatic direct carotid-cavernous fistulas by using Willis covered stent :report of one case[J].journal interventional radiology,2010,(07):300.
[4]朱悦琦,李明华,方淳,等.应用Willis覆膜支架治疗脑池段动脉瘤的临床对照研究和长期随访结果[J].介入放射学杂志,2010,(04):275.
 ZHU Yueqi,LI Minghua,FANG Chun,et al.Application of Willis covered stent in the treatment of aneurysms located in the cisternal segment of the internal carotid artery:a pilot comparative study with long-term follow-up results[J].journal interventional radiology,2010,(07):275.
[5]方亦斌,李建民,黄清海,等.支架辅助弹簧圈栓塞术治疗颈内动脉血泡样动脉瘤[J].介入放射学杂志,2010,(05):349.
 FANG Yibin,LIU Jianmin,HUANG Qinghai,et al.Treatment of blood blister-like aneurysms of the internal carotid artery with stent-assisted coil embolization[J].journal interventional radiology,2010,(07):349.
[6]章永强,林东,胡锦清.未破裂后交通动脉瘤致动眼神经麻痹血管内治疗疗效分析[J].介入放射学杂志,2010,(07):566.
 ZHANG Yongqiang,LIN Dong,HU Jinqing.Endovascular treatment of oculomotor nerve palsy caused by unruptured aneurysm of posterior communicating artery:an analysis of therapeutic effects[J].journal interventional radiology,2010,(07):566.
[7]陈宏颉,刘峥.经颈动脉途径治疗脑血管病变[J].介入放射学杂志,1998,(01):8.
[8]马耀斌,庞志宏,李晓光,等.脑动静脉畸形血管内栓塞治疗[J].介入放射学杂志,1998,(04):236.
[9]周平,张红,于志斌,等.在普通X线机下神经放射介入治疗的临床应用[J].介入放射学杂志,1995,(01):50.
[10]顾斌贤,李明华,王武.弹簧圈血管内栓塞颅内动脉瘤危急事件中支架的应用[J].介入放射学杂志,2011,(02):93.
 GU Bin-xian,LI Ming-hua,WANG Wu.Management of stent for an emergency situation during coil embolization of intracranial aneurysms[J].journal interventional radiology,2011,(07):93.

备注/Memo

备注/Memo:
(收稿日期:2013-11-13)
更新日期/Last Update: