血管内治疗脑动静脉畸形54例临床分析

54 cases of cerebral arteriovenous malformations(AVMs)treated by endovascular embolization

本文报告经血管内治疗脑动静脉畸形(AVMs)54例。AVMs<3cm 者6例,3～6cm 者33例,>6cm 15例。AVMs 栓塞达95%以上者8例,70%～95%者14例,50%～70%者22例,不足50%者10例。随访23例,除1例颅内出血外,余者临床症状均有改善。本组病例表明:单纯血管内治疗AVMs 可改善症状。将血管内治疗与手术切除或放射性治疗相结合,可提高 AVMs 治愈率,降低并发症和死亡率。

Fifty-four cases of AVMs treated by endovascularembolization are reported.There were 32 cases pre-sented with seizure,12 with intracranial haemorrhage,and headache or neurological deficit in the others.Thesize of the AVMs were less than 3 cm in 6 cases,6cmin 33 cases and more than 6 cm in 15 cases.After oper-ation more than 95% of AVM nidus was obliterated in8 patients,70% to 90% obliterated in 22 patients andless than 50% were occluded in 10 patients.Post-op-eratively the original symptoms subsided in the earlystages in 16 cases and 4 patients had additional neuro-logical deficits.Follow-up was carried in 23 patients,all were improved in their clinical symptoms,exceptone with delayed intracranial haemorrhage.In conclu-sion,endovascular embolization may ameliorate thesymptom of the patients combined preoperative en-dovascular embotization and direct sorgery could re-duce the complications death rate and promotion thetherapeutics rate.The techniques,embolizating materi-als,and complications are discussed too.