非粘附性栓塞材料Onyx栓塞治疗脑动静脉畸形疗效的临床研究

Endovascular treatment of cerebral arteriovenous malformations with Onyx embolization

目的：探讨用新型非粘附性液体栓塞材料Onyx（美国MTI公司产）栓塞脑动静脉畸形（arteriovenous malformation，AVM）的疗效。方法：2003年9月至2004年9月用微导管技术应用Onyx胶栓塞22例脑动静脉畸形。畸形团的位置：10例位于大脑重要功能区，8例位于大脑深部组织区，4例位于小脑半球。畸形团的直径：〈3cm5例，3—6cm11例，〉6cm6例。结果：22例脑动静脉畸形得到有效栓塞。其中，3例畸形团从影像上完全消失，8例90％以上消失，6例80％～90％消失，5例消失在80％以下。栓塞术后并发症少见，2例有短暂神经功能障碍，2例微导管头端粘附于畸形团内，无法撤出，微导管被留置于大血管内。结论：由于Onyx良好的非粘附性，可以向畸形团内注入更多的量，故在栓塞脑动静脉畸形是安全、有效的。

Objective： To explore the role of Onyx（Micro Therapeutics. Inc., Irvine, CA, USA）, a new liquid embolic material, on cerebral arteriovenous malformations（CAVMs）. Methods： From September 2003 to September 2004, Onyx was used to treat 22 cases of CAVMs. The malformation was located in functional areas in 10 cases, deep cerebral areas in 8 cases, and cerebellar hemisphere in 4 cases. The size of CAVMs was about 3 cm in 5 cases, 3 - 6 cm in 11 cases, and larger than 6cm in 6 cases. Results： Onyx embolization was successful in 22 cases, 3 of whom resulted in complete nidus occlusion, 8 〉 90%, 6 〉 80% and 〈 90%, and 5 〉 50% and 〈 80%.Two transient neurological deficits and two microcathetets glued to the injection site were found after treatment. Condusion： Because of its non-adhesive, Onyx is a safe and satisfactory embolic material for CAVMs, however, its longterm efficacy is to be followed up.