Onyx结合弹簧圈岩下窦入路栓塞海绵窦区硬脑膜动静脉瘘

Embolization of cavernous sinus dural arteriovenous fistulas through inferior petrosal sinus approach using Onyx combined with coils

目的：探讨应用Onyx结合弹簧圈岩下窦入路栓塞海绵窦区硬脑膜动静脉瘘（csDAVF）的优势及疗效。方法：对6例csDAVF患者应用Onyx结合弹簧圈岩下窦入路栓塞,并评价疗效。结果：6例采用＂股静脉-岩下窦＂入路成功栓塞csDAVF,4例csDAVF瘘口完全闭塞,出院时症状消失;2例csDAVF次全闭塞,出院时症状改善,随访1-2个月临床症状消失。全部病例随访1-12个月,未见症状复发。结论：经＂股静脉-岩下窦＂途径,较易到达病变部位;海绵窦为闭塞csDAVF瘘口的理想部位,Onyx能在海绵窦中形成良好弥散,结合弹簧圈的应用有利于瘘口的闭塞。

Objective：To discuss the superiority and curative effect of using onyx combined with coils in treatment with cavernous sinus dural arteriovenous fistulas （csDAVF） through inferior petrosal sinus （IPS） approach. Methods：6 ca- ses with csDAVF were embolized through IPS using onyx combined with coils, then the curative effect was assessed. Results： IPS approach was successfully conducted in all 6 cases. Fistulas were completely embolized in 4 cases, the symptoms disappeared on discharge from hospital near completely embolized in 2 cases, the symptoms were improved on discharge from hospital and disappeared during follow up duration from 1 to 2 months. All cases were followed up from 1 to 12 months,no symptom recurrence. Conclusion： It is easy to reach the lesion through IPS approach, the cavernous sinus is a perfect location for embolization of the fistulas. Onyx can diffuse easily in the cavernous sinus,and it is beneficial for the embolization of fistulas when combined with coils.