静脉支架成形治疗矢状窦复杂性硬脑膜动静脉瘘

The treatment of DAVF with stricture of drainage vein by implantation of stent

目的 探讨通过静脉支架植入改善硬脑膜动静脉瘘引流 ,治疗伴引流静脉狭窄的硬脑膜动静脉瘘的可行性及疗效。方法 1例上矢状窦 ,左侧横窦及颈静脉球区的复杂性硬脑膜动静脉瘘患者 ,伴右侧横窦闭塞 ,左侧颈静脉严重狭窄达 80 % ,矢状窦扩张 ,将支架植入狭窄静脉 ,改善静脉引流。结果 成功植入静脉支架 ,残余狭窄约 30 % ,症状明显改善 ,头痛逐渐消失 ,行走不稳消失 ,视力较前明显改善。 6个月后复查脑血管造影显示颈静脉支架位置形态好 ,无支架内狭窄 ,上矢状窦、横窦及乙状窦瘘口较前无明显变化。结论 静脉支架植入改善硬脑膜动静脉瘘引流 ,治疗伴引流静脉狭窄的硬脑膜动静脉瘘是可行的 ,其近期疗效满意 ,长期疗效有待进一步随访观察。

Objective Try to find out the feasibility and curative effect of the treatment of DAVF with stenosed drainage vein by implantation of stent.Methods A patient of complicated DAVF with stenosed drainage vein ,stent was implanted in the stenosed drainage vein to improve the function of vien. Results The procedure was successful. The symptom of the patient improved obviously. Cerebral angiography after six month revealed the fine shape and location of the stent. The fistulas of lateral sinus and sigmoid sinus showed no obvious change comparing with the formers.Conclusions The treatment of DAVF with stenosed drainage vein by implantation of stent is feasible. The short term curative effect is satisfactory and the long-term one is still wait for follow-up.