经静脉治疗硬脑膜动静脉瘘的效果

EFFECT OF TRANSVENOUS TREATMENT ON DURAL ARTERIOVENOUS FISTULA

①目的 观察经静脉栓塞、手术和压迫方法治疗硬脑膜动静脉瘘 (DAVF)的效果。②方法 对 6例DAVF首选经静脉方法治疗。 3例位于上矢状窦区 ,手术夹闭引流静脉 2例 ,部分栓塞 1例 ;3例位于海绵窦区 ,单纯压迫眼静脉治疗 1例 ,经静脉途径栓塞失败后压迫眼静脉治疗 2例。③结果 4例治愈 ,1例有效 ,1例无变化。④结论 经静脉手术、栓塞上矢状窦区DAVF是一安全有效手段 ;经股静脉途径栓塞海绵窦区DAVF导管到位困难 ,而压迫眼引流静脉确实有效 ,可辅助治疗栓塞未愈病人。

Objective To observe the outcome of the treatment of dural arteriovenous fistula(DAVF) by venous ligation, embolization and compression. Methods Six DAVF patients were treated by venous approach. Of which, three involved the superior sagittal sinus(SSS), two were treated by ligation of draining veins through craniotomy, and the other one partially embolized; the other three involved cavernous sinus(CS), two failed to be occluded through transvenous pathway and cured by compression of the eye vein, one was treated by compression of the eye vein only. Results Four cases were cured, one improved, and the other one remains unchanged. Conclusion Transcranial venous ligation and transvenous embolization of SSS-involved DAVF are effective and safe. It is difficult to insert microcatheter for embolization of the fistula through transfemoral venous for CS-involved DAVF. Compression of the eye vein is a reliable aid for the treatment of incomplete embolization.