液态栓塞剂Onyx治疗脑动静脉畸形

A Nonadhesive Liquid Embolic Agent of Onyx for the Treatment of Cerebral Arteriovenous Malformations

目的总结液态栓塞剂Onyx治疗脑动静脉畸形(cerebral arteriovenous malformation,cAVM)的应用和经验。方法 2006年7月～2011年3月应用液态栓塞剂Onyx成功治疗cAVM23例,畸形团的大小<3 cm7例,3～6 cm(含3cm和6cm)12例,>6 cm 4例。均采用Seldinger技术在股动脉置入动脉鞘,导管通过动脉鞘进入颈内动脉或椎动脉,微导管和微导丝超选择进入畸形血管团,缓慢注入Onyx液态栓塞剂栓塞动静脉畸形。结果栓塞后cAVM 5例完全消失,8例达90%以上,7例达80%～90%,3例在80%以下,5例在行Onyx胶栓塞术后3个月再次行Onyx胶栓塞,8例Onyx胶栓塞后3个月改行γ刀放射治疗。1例颅内血肿遗留,对侧肢体偏瘫,其余病例术后无神经功能障碍。结论 Onyx液态胶对cAVM的栓塞具有明显的效果,具有创伤小,患者恢复快的优点,但应正确采用栓塞技术和注意防止并发症。

Objective To investigate the application and experience of the liquid embolic agent Onyx for the treatment of cerebral arteriovenous malformation（cAVM）.Method From July 2006 to March 2011,the liquid embolic agent Onyx was used for the treatment of cAVM in 23 cases.The diameter of cAVM was less than 3cm in 7 cases,3~6 cm in 12 cases,more than 6cm in 4 cases.The Seldinger technique was applied for the Onyx embolization.Results After the embolization of the cAVM,5 cases got completely disappear,8 cases got more than 90% embolization,7 cases of 70% to 90% and 3 cases of 70% or less.There were 5 cases needed a second Onyx embolization and 8 patients needed postoperative adjuvant gamma knife treatment.One case occurred contralateral hemiplegia because of the remained intracranial hematoma.The other cases had no postoperative neurological dysfunction.Conclusion It is recommended of the Onyx liquid glue for the embolization for cAVM,with advantages of significant results,less trauma,quick recovery.But it should be noted of the correct use of embolization and the prevention of complications.