高压锅技术在介入治疗硬脑膜动静脉瘘中的应用研究

The Application of High Pressure Pot Technique in the Interventional Treatment of Dural Arteriovenous Fistula

目的探讨高压锅技术栓塞硬脑膜动静脉瘘的可行性及预后。方法收集重庆医科大学附属第一医院2015年9月~2017年6月应用高压锅技术介入栓塞治疗硬脑膜动静脉瘘的病例17例,根据病变部位对病例分类,术中、术后造影评估手术效果,改良Rankin量表评估预后。结果 17例硬脑膜动静脉瘘患者使用高压锅技术经动脉途径行血管内治疗,术后即刻造影,11例患者(64.71%)完全栓塞,6例患者(35.29%)残存少许微小供血动脉。无危险吻合、出血、缺血、面神经麻痹等并发症。术后6个月随访,m Rs评分0分12例(70.59%),1分5例(29.41%)。结论以高压锅技术经动脉途径栓塞硬脑膜动静脉瘘是安全有效的,手术效果及预后佳,术后无明显并发症,短期随访效果佳,长期疗效有待进一步随访,操作中仍需注意危险吻合。

Objective To investigate the feasibility and prognosis of the high pressure pot technique for the embolization of the dural arteriovenous fistula.Methods Collection of the First Affiliated Hospital of Chongqing Medical University from September 2015 to June 2017.17 cases of dural arteriovenous fistula were treated with an the high pressure pot technique to treat embolism.Classification of cases was based on the lesion location,and the intraoperative and postoperative angiography was used to evaluate the surgical outcome.Modified Rankin scale to assess prognosis.Results 17 patients with dural arteriovenous fistulas were treated with endovascular treatment via arterial route by the high pressure pot technique.Immediately after angiography,11 patients(64.71%)were completely embolized and 6 patients(35.29%)survived.No risk of anastomosis,bleeding,ischemia,facial nerve paralysis and other complications.After 6 months of follow-up,the mRs score was 0 points in 12 cases(70.59%),1 in 5 cases(29.41%).Conclusion The arterial embolization of dural arteriovenous fistula by the high pressure pot technique is safe and effective.The surgical outcome and prognosis are good.There is no obvious postoperative complications.The short-term follow-up results are good.Long-term efficacy needs further follow-up.Dangerous anastomosis is still required during operation.