血管内介入治疗硬脑膜动静脉瘘7例分析

The clinical analysis ofdural arteriovenous fistula treated by intravascular interventional methods

目的探讨分析血管内介入治疗硬脑膜动静脉瘘的方法与疗效。方法回顾性分析安徽医科大学第一附属医院神经外科2012年1月至2016年5月收治的7例硬脑膜动静脉瘘（DAVF）患者临床资料,其中经动脉途径栓塞6例,经静脉途径栓塞1例,均应用Onyx胶予以栓塞。结果 7例患者术后即刻造影显示栓塞完全,无死亡病例,无新发神经功能缺失症状,1例海绵窦DAVF患者术后第3天球结膜充血症状完全缓解,所有患者随访3-24个月未出现新发神经功能缺失症状。结论根据影像学特点,针对不同类型的DAVF选用不同的栓塞途径,血管内栓塞DAVF是微创、安全、有效的治疗方法,可作为DAVF的首选治疗方法。

Objective To investigate and summarize methods and efficacy of the vascular interventionalmethods in the treatment of dural arteriovenous fistula（DAVF）. Methods A retrospective analysis of the clinical data of seven DAVF patients in our department from January 2012 to May 2016 was performed. Six patients with DAVF were cured by arterial embolization and one patient was treated by transvenous approach embolization. Both patients were embolized by the application of the Onyx gel. Results All seven cases accepted angiography immediately after the operation,and results showed that all DAVF was embolized entirely,no patient died and no new neurological deficit symptomswere found. One patient with DAVF located at the cavernous sinus had conjunctival congestion,and the symptoms were completely relieved three days after the operation. All patients were followed up for 3 to 24 months and no new neurological deficit symptomsappeared. Conclusion According to the imaging characteristics,different types of DAVF could employ different embolism approach. Endovascular embolization of DAVF is a minimally invasive,safe and effective treatment method. Endovascular interventional therapy can beused as the first choice for most DAVF.