Onyx栓塞治疗脑中央区动静脉畸形

Endovascular embolization with Onyx for the treatment of brain arteriovenous malformations located in the centre-encephalic region

目的探讨Onyx胶栓塞治疗脑中央区动静脉畸形的效果。方法选择18例脑中央区动静脉畸形患者,按Drake标准分为小型10例、中型6例、大型2例,应用Onyx胶共行24次血管内栓塞治疗。结果经治疗后,完全栓塞12例(66.7%),致残(症状较术前加重)2例(11.1%),其中中型组完全栓塞3例(50%),与小型组完全栓塞9例(90%)比较差异有统计学意义(P<0.05),无死亡病例。供血动脉长度大于2cm与小于2cm完全栓塞比较差异有统计学意义(P<0.05)。结论Onyx胶栓塞治疗脑中央区动静脉畸形安全有效,畸形团大小和供血动脉长度对完全栓塞率有一定影响。

Objective To evaluate endovascular embolization with Onyx in treating brain arteriovenous malformations （AVM） located in the centre-encephalic region. Methods Eighteen patients with AVM in the brain centre-encephalic region were treated with embolization by using Onyx. According to Drake criteria of the AVM type, small type was seen in 10, medium type in 6 and large type in 2 cases. By using Onyx as embolization material, a total of 24 endovascnlar procedures were carried out. Results After treatment, complete obliteration was obtained in 12 cases （66.7%）, disability （symptoms worsened） resulted in 2 cases （11.2%） and no death occurred. In the medium type group and the small type group complete obliteration was seen in 3 （50%） and 9 （90%） cases respectively, the difference between the two groups was significant （P 〈 0.05）. Significant difference in complete obliteration rate existed between the patients with the feeding artery length 〉 2 cm and the patients with the feeding artery 〈 2 cm. Conclusion Embolization with Onyx is a safe and effective treatment for AVM located in the brain centre-encephalic region. Both the size of the abnormal vascular plexus and the length of the feeding artery carry a certain correlation with the complete obliteration rate.