脑动静脉畸形血管内治疗73例临床分析

Clinical analysis of 73 cases with arteriovenous malformation treated by endovascular therapy

为观察经血管内注入栓塞材料治疗脑动静脉畸形（AVMS）的疗效。65例脑AVMS用真丝线段栓塞，8例用α-氰基丙烯酸正丁酯（NBCA）栓塞，通过微导管注入脑AVMs内。结果：完全栓塞131（1％），栓塞病变90％以上21例（29％），70％～90％26例（35％），50％～70％8例（11％），栓塞2次。7例（10％），症状改善者70例（96％），神经功能缺失者4例（5％），66例治疗后经颅多普勒超声（TCD）测定平均流速明显减少，栓塞前109．527±29．61至栓塞后75．76±28．362，搏动指数增加，栓塞10．542±0．184至栓塞后0．738±0．19。结果提示：使用真丝线段或NBCA栓塞治疗脑AVMS效果较好，部分病变如能结合手术切除或伽马刀治疗可提高治愈率。

To study the Intravascular injecting embolizing material for treatment of brain arteriovenous malformation (AVMs), pure silk segments were injectedg into AVMs through microcatheter, in 65 cases, and NBCA was injected in & cases. Complete embolization accursed 13 cases (18% ); more than 90% embolization in 21 cases (29% ) and 70% -90% embolization in 7 cases (10% ). Symptoms were improved in 70 cases (96% ) and neurolo-gical function were deficint in 4 cases (5% ). In 66 cases TCD examination showed that the mean blood velocity reduced greatly. from 109. 527±29. 61 (before treatment) to 75. 76±28. 362 (after treatment ). Pulse index incerased. Embolization using silk segment or NBCA is a good method for AVMs, it may be better to combine with surgrey in some cases.