丙泊酚Wada试验在脑功能区动静脉畸形栓塞中的应用

Value of super-selective Wada testing with propofol in embolization of cerebral arteriovenous malformations in functional regions of the cerebral cortex

目的探讨超选Wada试验在脑功能区动静脉畸形栓塞中的应用效果。方法回顾性分析2013年5月至2016年5月收治的36例脑功能区动静脉畸形的临床资料,术前进行超选造影并用丙泊酚在超选的动脉完成Wada试验,再选择Onyx胶栓塞畸形血管团。结果 Wada试验中,3例出现抽搐、颤抖或不随意运动而放弃栓塞,7例出现运动障碍、4例语言障碍、2例记忆障碍而放弃栓塞治疗;其余20例共栓塞24次,每例栓塞l^3次,平均1.2次,完全栓塞8例。栓塞的20例中,发生缺血性并发症1例,无出血性并发症;术后随访2~23个月,无死亡病例,轻度神经功能障碍1例。结论动脉超选行Wada试验进后,行脑功能区动静脉畸形的栓塞,可减少术后并发症的发生率。

Objective To investigate the effect of the super-selective Wada testing with propofol on the embolization of niduese in functional regions of the cerebral cortex in the patients with cerebral arteriovenous malformations （AVM）. Method The clinical data of 36 patients with cerebral AVM in the functional regions hospitalized from May, 2013 to May, 2016 were analyzed retrospectively. The Wada testing with propofol was performed during the super-selective cerebral artery angiography in all the patients, and then the niduese were embolized with Onyx giue according to the results of the Wada testing. Results Of 36 patients with cerebral AVM, 20 received endovascular embolization and 16 did not due to the adverse reactions to Wada testing including convulsions and movement and language disorders. The niduese were completely embolized in 8 patients and incompletely in 12 patients. Of the 20 patients with embolization by Onyx glue, 1 had ischemic stroke, 1 mild neurological dysfunction and 18 were recovered well during the following-up from 2 to 23 months after the embolization. Conclusion The super-selective Wada testing may be helpful to reducing the incidence of post-embolization complications in the patients with cerebral AVM in the functional regions.