脑动静脉畸形的微导管血管内栓塞治疗

Endovascular embolization of brain arteriovenous malformation through microcatheter.

目的 评价微导管血管内栓塞术对脑动静脉畸形 (AVM)的治疗价值。方法 采用微导管超选择性插管用真丝线段、NBCA及 PVA栓塞治疗 2 8例脑 AVM病人。结果 2 8例 AVM病人 31次栓塞 ,成功率 97%。栓塞 5 0 %以上者 82 % ,其中完全栓塞 18%。栓后症状减轻、消失 ,有效率达 86 %。随访 5月～ 8年 ,未再发生出血。术中血管痉挛 5例(16 % ) ,2例致导管嵌顿、滞留颅内。 1例 (3% )偏瘫、失语 ,经处理 1月后恢复 ,均未遗留神经功能障碍。结论 微导管血管内栓塞治疗脑 AVM损伤小 ,疗效肯定 ,并发症少 ,可以作为综合治疗脑 AVM的一个重要组成部分。

Objective To evaluate the usefulness of the endovascular embolization through microcatheter for the brain arteriovenous malformation(AVM).Methods 28 patients with AVM was embolized with silk thread,NBCA and/or PVA through microcatheter.Results All but one patients were successfully embolized.The success rate was 97%.The AVM nidus in 82% of the cases was reducd in size by 50% and over,and it was completely obliterated in 18% of the cases.The improvement or disappear ance of the symptoms was achieved in 86% of the cases after embolization.No recurrence and rebleeding occurred in the follow-up period from 5 months to 8 years.Vessel spasm appeared in 5 cases(18%),and in two of them the catheter tips were incarcerated and detained in the intracranial vessels.Transient hemiparesis and aphasia took place in one case(3%).No residual dysneuria or sequela was noted in these 6 cases after suitable treatments.Conclusion The endovascular embolization through microcatheter is effective,less harmful and less liable to complications;it serves as an important part in the comprehensive treatment of the brain AVM.