硬脑膜动静脉瘘血管内栓塞治疗的实验和临床

Experimental and Clinical study of Endovascular Embolization for Dural AVF(DAVF)

目的 通过动物实验揭示DAVF的发病机理;临床中探索最佳治疗方法。方法 对3组狗作不同处理,诱发DAVF;临床中依病情采用不同的栓塞方法,以获得临床治愈。结果 实验组中共有4只动物发生DAVF;39例病人中,临床治愈23例,好转12例,死亡1例。结论 静脉窦内压增高是诱发DAVF病因之一;血管内栓塞对DAVF的治疗效果可靠,但必须针对病情采用不同的栓塞方法,或是联合治疗。

Objective To explore the pathogenetic mechanism in the development of DAVF and evaluate the therapeutic efficacy of endovascular treatment with different approaches. Methods In the experimental study, different processing ways were adopted in 30 dogs for creating different gradient of endovascular pressure so as to induce the DAVF in part of these animals, another 10 dogs served as control. Different strategy of endovascular embolization were clinically employed according to the conditions of patients to achieve clinical cure of patients with DAVFs. Results Cerebral angiographic findings, pathological studies and blood-gas analysis demonstrated that 4 of the 30 dogs developed DAVF. Among the 39 patients with DAVF, clinical cure was obtained in 23, improvement in 12 and death occurred in one case. Conclusions The authors concluded that increase in pressure within the venous sinuse was one of the pathologenetic factors responsible for the development of DAVF. Endovascular embohzation is a reliable and effective method for treatment of DAVF, but the therapeutic option to be adopted should depend on the conditions of the patient.