脊髓血管畸形的血管内栓塞治疗（附九例报告）

Intravascular Embolization of Splnal Arteriovenous Malformation(A Report of 9 Cases)

作者报道了９例经数字减影血管造影（ＤＳＡ）确诊后同时进行血管内栓塞治疗的脊髓血管畸形（ＡＶＭ）病例。根据ＤＳＡ显示的异常血管的部位、形态、分布和供血动脉及引流静脉情况将其分为两型：硬膜动静脉屡（ＡＶｎ型和硬膜内ＡＶＭ型，然后经导管注入栓塞物质进行栓塞治疗。栓塞后造影显示ＡＶＭ大部或完全消失，６例栓塞程度达１００％，平均９２．２％。在２个月至３年的随访期内，７例肢体肌力增加，症状明显改善。栓塞后反应主要有发热、胸腰背痛或束带状感觉异常，但均在数天内恢复。结果提示栓塞可导致脊髓ＡＶＭ的血供中断和临床症状的改善，是一种有效、安全的治疗措施。作者对脊髓ＡＶＭ的ＤＳＡ表现，临床特征，栓塞材料和治疗效果进行了讨论。

Nine cases with arteriovenous malformation(AVM)of spinal cord diagnosed by digital substraction angiography(DSA) and treated by intravascular embolization were reported.Ac-cording to the location and shape. distribution of abnormal vessels. feeding arteries and draining veins displayed by DSA. the disease was divided into two types:dural arteriovenous fistula(AVF)and intradural AVM. Embolization treatment was carried out by injecting embOlizing materials through catheter. After embolization. angiography revealed that AVM disappeared mostly or totally.The degree of embolization in 6 cases was 100%(mean 92.2%).During follow- up of 2 months to 3 years. 7 of 9 patients improved.The main reactions to embolization were fever. backache.lumbago or beItlike sensory abnormality.but all of them recovered within several days. The results suggested that embolization could result in obliteration of blood flow supplying the spinal AVM and improve-ment of clinical symptoms. It is an effective and relatively safe procedure.The DSA manifestations.clinical features. treatment effect of spinaI AVM and embolic materials were discussed.