血管内栓塞治疗脑动静脉畸形的探讨

The approach of treatment of cerebral arteriovenous malformation with endovascular embolization.

目的探讨血管内栓塞治疗在脑动静脉畸形综合治疗中的作用及其技术要点。方法对87例脑动静脉畸形应用微导管技术,在数字减影血管造影监视下行血管内栓塞治疗。结果成功栓塞脑动静脉畸形87例恢复良好82例,5例中度致残,生活自理。87例病人共行105次栓塞,单个病例栓塞次数1-7次。平均1.2次。100%栓塞19例,90%-者栓塞19例,80%-者栓塞10例,70%-者栓塞12例,60%-者栓塞10例,60%以下栓塞17例。共栓塞325支供血动脉。栓塞后42例行手术治疗,15例行γ-刀治疗。术中出血4例。结论血管内栓塞治疗脑动静脉畸形安全可靠,是脑动静脉畸形综合治疗中的重要组成部分。

Objective To verify the effectiveness and safety of the endovascular embolization in the treatment cerebral arte-riovenous malformation. Methods 87 patients underwent embolization with the microcatheter technique under digital subtraction angiography(DSA) monitoring. Results 87 patients underwent 105 times of embolization therapy, and single case underwent 1 -7 times, averagely, 1.2 times. Complete obliteration of the nidus was achieved in 19 patients, 90% in 19, 80% in 10, 70% in 12, 60% in 10 and below 60% in 17 reskectively. 42 patients received surgery after the embolization. 15 patients received γ-knife treatment. Among the 87 patients, 82 patients fully recovered, while 5 patients suffered from moderate persistent neurologic deficits. Conclusions Endovascular embolization of the cerebral arteriovenous malformations is effective and relatively safe.