硬脑膜动静脉瘘单次血管内栓塞治疗的安全性和有效性分析

Safety and efficacy of a single endovascular treatment for patients with dural arteriovenous fistulas

目的 探讨单次血管内栓塞治疗硬脑膜动静脉瘘(DAVF)的安全性和有效性。方法 回顾性分析2005年4月至2018年12月采用血管内栓塞治疗的46例DAVF的临床资料。所有病例均尝试进行单次瘘口栓塞术,对部分残余分流或软脑膜静脉逆行引流(RLVD)的病例则择期二次手术。结果 42例(91.3%)单次手术治疗后实现完全闭塞或仅轻微残余分流。34例Borden分型Ⅱ、Ⅲ型病例中,33例(97.1%)首次治疗后RLVD明显改善,仅4例需要二次治疗。所有病例最终均完全闭塞,术后未发生与DAVF相关的卒中和死亡事件。术后随访7~96个月,平均23个月;4例(8.7%)复发。结论 单次血管内手术治疗DAVF是安全、有效的,能有效预防卒中事件。

Objective To investigate the safety and efficacy of a single endovascular treatment(EVT)for patients with dural arteriovenous fistulas(DAVFs).Methods The clinical data of 46 patients with DVAFs who underwent EVT from April 2005 to December 2018 were analyzed retrospectively.A single embolization was attempted in all patients,and secondary embolization was performed for partial residual shunt or retrograde leptomeningeal venous drainage(RLVD).Results A complete occlusion or minor residual shunt was achieved in 42 patients after a single embolization.Of 34 patients with Borden typesⅡandⅢ,33 patients(97.1%)showed significant improvement in RLVD after the first embolization,and only 4 patients needed second embolization.A complete occlusion was achieved in all patients without postoperative DAVF-related stroke or death.The follow-up ranged from 7 months to 96 months,with a mean time of 23 months.Four patients(8.7%)recurred.Conclusions A single endovascular embolization is safe and effective for patients with DAVF,and can effectively prevent stroke events.