[1]王威,盖延廷,檀书斌,等.可解脱微导管结合增压技术栓塞脑动静脉畸形[J].介入放射学杂志,2020,29(04):345-349.
 WANG Wei,GAI Yanting,TAN Shubing,et al.Embolization of brain arteriovenous malformation by using detachable tip microcatheter plus pressure cooker technology[J].journal interventional radiology,2020,29(04):345-349.
点击复制

可解脱微导管结合增压技术栓塞脑动静脉畸形()

PDF下载中关闭

分享到:

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

卷:
29
期数:
2020年04
页码:
345-349
栏目:
神经介入
出版日期:
2020-05-08

文章信息/Info

Title:
Embolization of brain arteriovenous malformation by using detachable tip microcatheter plus pressure cooker technology
作者:
王威盖延廷檀书斌彭方强孙伟刘旻谛叶宇阳宋冬雷
Author(s):
WANG Wei GAI Yanting TAN Shubing PENG Fangqiang SUN Wei LIU Mingdi YE Yuyang SONG Donglei.
Department of Neurosurgery, Punan Hospital of Pudong New District, Shanghai 200125, China
关键词:
【关键词】 脑动静脉畸形治愈性栓塞Apollo可解脱微导管近端血流阻断增压技术
文献标志码:
A
摘要:
【摘要】 目的?探讨可解脱微导管结合近端血流阻断增压技术(PCT)栓塞脑动静脉畸形(bAVM)的疗效及并发症。方法?前瞻性队列研究2016年1月至2018年12月冬雷脑科医生集团上海浦南医院采用Onyx胶经动脉途径栓塞治疗bAVM患者133例,其中Spetzler-Martin分级Ⅰ级10例,Ⅱ级54例,Ⅲ级49例,Ⅳ级18例,Ⅴ级2例。按时间段将患者分为A组(n=70,2016年1月至2018年2月结合非解脱微导管)、B组(n=63,2018年3月至12月结合Apollo可解脱微导管),对B组中30例采用PCT。分析两组患者疗效及并发症发生率等。结果?133例患者bAVM总栓塞率为33.8%(45/133);
A组栓塞率为25.7%(18/70),B组为49.2%(31/63), 差异有显著统计学意义(P<0.01);B组中PCT技术组栓塞率为66.7%(20/30),非PCT技术组为33.3%(11/33), 差异有统计学意义(P<0.05)。并发症发生在A组为5.7%(术中微导管粘管1例,术中出血1例,术后出血2例,其中1例死亡),B组为4.8%(术后出血3例,其中1例转外科手术)(P>0.05),总体并发症发生率为5.3%,无新发神经功能障碍。132例患者随访3~26个月(平均8个月),再发出血3例,其中1例死亡,完全栓塞患者无一例复发或再生血管畸形。131例患者中改良Rankin 量表(mRS)评分0~1分106例,2分25例。结论?经动脉途径采用Apollo可解脱微导管结合PCT技术栓塞治疗bAVM,可在不增加相关并发症情况下提高栓塞治
愈率。

参考文献/References:

[1] Stapf C, Mast H, Sciacca RR, et al. The New York islands AVM study:design, study progress, and initial results[J]. Stroke, 2003, 34:e29-e33.
[2] da Costa L, Wallace MC, Ter Brugge KG, et al. The natural history and predictive features of hemorrhage from brain arteriovenous malformations[J]. Stroke, 2009, 40:100-105.
[3] 盖延廷, 宋冬雷, 沈衍超, 等. 近端血流阻断增压技术治愈性栓塞颅内动静脉畸形[J]. 中国脑血管病杂志, 2015, 12:526-529.
[4] Richling B, Killer M, Al-Schameri AR, et al. Therapy of brain arteriovenous malformations: multimodality treatment from a balanced standpoint[J]. Neurosurgery, 2006, 59:S148-S157.
[5] Krings T, Hans FJ, Geibprasert S, et al. Partial “targeted” embolisation of brain arteriovenous malformations[J]. Eur Radiol, 2010, 20:2723-2731.
[6] Blackburn SL, Ashley WW, Rich KM, et al. Combined endovascular embolization and stereotactic radiosurgery in the treatment of large arteriovenous malformations[J]. J Neurosurg, 2011, 114:1758-1767.
[7] de Castro-Afonso LH, Nakiri GS, Oliveira RS, et al. Curative embolization of pediatric intracranial arteriovenous malformations using onyx: he role of new embolization techniques on patient outcomes[J]. Neuroradiology, 2016, 58:585-594.
[8] 徐?锋, 宋冬雷. 大型脑动静脉畸形的栓塞策略和技巧[J]. 中华神经外科杂志, 2014, 30:98-100.
[9] Elsenousi A, Aletich VA, Alaraj A. Neurological outcomes and cure rates of embolization of brain arteriovenous malformations with n-butyl cyanoacrylate or onyx:a meta-analysis[J]. J Neurointerv Surg, 2016, 8:265-272.
[10] Yu SC, Chan MS, Lam JM, et al. Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure[J]. AJNR Am J Neuroradiol, 2004, 25:1139-1143.
[11] Flores BC, See AP, Weiner GM, et al. Use of the Apollo detachable-tip microcatheter for endovascular embolization of arteriovenous malformations and arteriovenous fistulas[J]. J Neurosurg, 2018, 130:963-971.
[12] Maimon S, Strauss I, Frolov V, et al. Brain arteriovenous malformation treatment using a combination of Onyx and a new detachable tip microcatheter, SONIC: short-term results[J]. AJNR Am J Neuroradiol, 2010, 31:947-954.
[13] Chapot R, Stracke P, Velasco A, et al. The pressure cooker technique for the treatment of brain AVMs[J]. J Neuroradiol, 2014, 41:87-91.
[14] Abud DG, de Castro-Afonso LH, Nakiri GS, et al. Modified pressure cooker technique:an easier way to control onyx reflux[J]. J Neuroradiol, 2016, 43:218-222.
[15] He Y, Bai W, Li T, et al. Curative transvenous embolization for ruptured brain arteriovenous malformations: a single-center experience from China[J]. World Neurosurg, 2018, 116:E421-E428.
[16] 朱仕逸, 张?广, 亓敬涛, 等. 经静脉途径治疗脑动静脉畸形研究进展[J]. 介入放射学杂志, 2017, 26:1147-1150.

















相似文献/References:

[1]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,(03):185.
 ,,et al.Intracranial hemorrhage due to embolization therapy for cerebral arteriovenous malformation: its causes and management [J].journal interventional radiology,2012,(04):185.
[2]张 雷,赵 卫,姜永能,等. 脑动静脉畸形栓塞治疗中正常灌注压突破防治的研究进展[J].介入放射学杂志,2012,(06):524.
 ZHANG Lei,ZHA0 Wei,JIANG Yong-neng,et al. The prevention and treatment of normal perfusion pressure breakthrough syndrome occurred during embolization therapy for cerebral arteriovenous malformations: recent progress in clinical research[J].journal interventional radiology,2012,(04):524.
[3]朱仕逸,张 广,亓敬涛,等.经静脉途径治疗脑动静脉畸形研究进展 [J].介入放射学杂志,2017,(12):1147.
 ZHU Shiyi,ZHANG Guang,QI Jingtao,et al.Research progress in embolization treatment for cerebral arteriovenous malformations via transvenous approach[J].journal interventional radiology,2017,(04):1147.

备注/Memo

备注/Memo:
(收稿日期:2019-05-07)
(本文编辑:边?佶)
更新日期/Last Update: 2020-05-06