硬脑膜动静脉瘘血管内治疗(附11例报告)

Intravascular Treatment of Dural Arteriovenous Fistula

报道11例硬脑膜动静脉瘘,病因与静脉窦部分或全部狭窄、闭塞以及与外伤有关。颈外动脉供血为主,颈内动脉、椎动脉也可联合供血,引流也很复杂。全脑血管造影可确立诊断。手术结扎供血动脉可暂时缓解症状,但瘘口依然存在,很快复发。经血管内动脉联合静脉治疗,将微导管超选择送至近瘘口处,用不同的栓塞材料Ivalon、Coil、真丝微粒、线段、IBCA闭塞瘘口是较理想的治疗方法。Ivalon在AVF中弥散度较好,栓塞效果可靠。本组全部经血管内栓塞治疗,获满意效果。

Eleven cases of dural arteriovenous fistula (DAVF)were reported herewith. The etiology comprised of par-tial or complete occlusion and stenosis of venous sinus,as well as trauma. Blood supply mainly came from external carotid artery ,internal crotid artery and vertebral artery might contribute too. The drainages were complex. Cere-bral angiography cleared the diagnosis. Operative ligation could occlude the supplying arteries and released the symptoms temporarily rowever ,the fistula still existed and could induce the recurrence- Intravascular treatment was an ideal method. By superselective catheterization into the fistula,a variety of embolic materials such as Ival-on,Helicol Coil,Silk Article,Thread and IBCA Glue were used to embolize the fistula. Among those materials,1-valon diffused better than the others, making the efficacy concrete. All our patients underwent intravascular treatment and the outcome were satisfactory.