超选择性栓塞治疗椎管内血管畸形

Intravertebral canals vascular malformations treated by superselective embolization

目的 探讨采用微导管超选择性栓塞治疗椎管内血管畸形的可行性。 方法 12 8例椎管内血管畸形患者 ,行微导管超选择插入病变供血动脉及瘘口 ,注入真丝线段、Ivalon微粒或钨丝微弹簧圈。 结果 12 0例患者病变及瘘口完全消失 ,8例栓塞 6 0 %～ 80 %。症状明显改善 113例 ,其中 8例栓塞后肌力由Ⅰ级恢复到Ⅳ级 ;32例由Ⅱ级恢复到Ⅲ级 ;32例由Ⅲ级恢复到Ⅳ级 ;4 1例由Ⅳ级恢复到Ⅴ级。 15例患者栓塞后症状无明显改善 ,7例入院时肌力 0级 ,栓塞 1年后 2例恢复生活自理。 结论 采用微导管超选择性栓塞治疗椎管内血管畸形 ,是行之有效的一种新方法。

Objective To assess the feasibility superselective embolization using microcatheters in treatment of intravertebral canal vascular malformation. Methods In 128 patients with intravertebral canals vascular malformation, their AVMS or fistulae were treated with silk thread,Ivalon microspheres or tungsten microcoils Results In the 128 patients, 120 fistulae disappeared completely, but 8 were embolized 60% 80%. Symptoms were inproved in 113 patients. Improved muscular strength from grade Ⅰ to Ⅳ was obtained in 8 patients,from grade Ⅱ to Ⅲ in 32 ,from grade Ⅲ to Ⅳ in 32, and from grade Ⅳ to Ⅴ in 41 The symptoms did not change in 15 patients Conclusion Superselective embolization through microcatheter is effective in the treatment of intraspinal canal vascular malformations