腦動靜脈瘻的血管構築及治療方法分析

目的探討腦動靜脈瘻(AVFs)的血管構築特點及相應的治療策略。方法回顧性分析8例AVFs患者的血管構築特點及相應的治療方法,特別是血管内介入治療材料對治療方法的影響。結果Ⅰ型1例,Ⅱ型2例,Ⅲ型5例。全部進行血管内介入治療,單用NBCA的2例,球囊輔助NBCA1例,聯合使用彈簧圈和NBCA1例,單用彈簧圈的1例,聯合使用NBCA和Onyx1例,球囊輔助Onyx2例。術後影像學治癒7例,好轉1例。結論AVFs的治療方法由其血管構築特點決定,隨著血管内介入治療材料的進步、介入成爲首選和最主要的手段。

Objective In this article we discus the angioarchitectual characteristics of cerebral arteriovenous fistulas(AVFs)and its appropriate therapeutic strategies.Methods A total of 8 patients with AVFs were retrospectively analyzed,including the patterns of angioarchitecture and the endovascular treatment,focusing on the effect of embolic materials.Results There are tree different types of fistula in our study,including type Ⅰ(1),type Ⅱ(2)and type Ⅲ(5).All the 8 cases underwent flow disconnection by endovascular approach,using NBCA in 2 cases,using NBCA assisted with transient balloon occlusion in 1 case,using a combination of coil and NBCA in 1 case,using coil in 1 case,using a combination of NBCA and Onyx in 1 case,using Onyx assisted with transient balloon occlusion in 2 cases.Post-embolisation angiograms show complete obliterated in 7 lesions and near total obliterated in 1 lesion.Conclusion The treatment depends on the angioarchitecture.Endovascular treatment becomes to the first choice and chief approach with the development of endovascular materials.