前颅窝底硬脑膜动静脉瘘的经动脉入路治疗

Transarterial treatment of dural arteriovenous fistulas in anterior cranial fossa

目的评价经动脉入路栓塞前颅窝底硬脑膜动静脉瘘(DAVF)的临床疗效。方法分析6例有症状前颅窝底硬脑膜动静脉瘘(DAVFs)经动脉血管内治疗技术和结果。结果 6例经动脉入路插入导管用Onyx-18胶栓塞。本组病例在治疗过程中都能接近瘘口处并栓塞动静脉分流区域。最后血管造影显示DAVF完全闭塞。治疗后没有观察到相关后遗症,6例均进行临床随访,GOS评分均为5。6例获脑血管造影随访,均未见瘘口显影。结论经动脉入路栓塞前颅窝底DAVFs是可行的。

Objective To evaluate the clinical efficacy of the transarterial embolization oi dural arteriovenous fistula （DAVF） in anterior cranial fossa. Methods The technique and results of the endovascular treatment in six symptomatic patients with anterior cranial fossa dural arteriovenous fistulas （DAVFs） were analyzed. Results Catheterization was via transarterial approach for 6 patients. Embolization was performed using a liquid embolic system （Onyx-18, MTI ） in the transarterial approach patients. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs and all patients recovered completely. No posttreatment complications related were observed. All patients were followed up, the Glasgow outcome scale （GOS） score was 5 in 6. Angiographic follow up was obtained in 6 patients and no fistula was observed. Conclusion Transarterial embolization of anterior cranial fossa DAVFs is feasible by transarterial access.