CAVM栓塞剂NBCA混悬液配比浓度的基础和临床研究

Basic and clinic study of the density proportion in forming AVM embolic agent-NBCA mixed liquid.

目的 定量分析动静脉畸形 (AVM)栓塞剂α 氰基丙烯酸丁酯 (NBCA)混悬液配比与动 静脉 (A V)循环时间之间的关系 ,探讨临床应用微导管栓塞脑AVM (CAVM )所需的最佳NBCA混悬液配比浓度。方法 ① 16例颅内出血患者的离体新鲜动脉血和浓度分别为 2 0 %、33%、5 0 %、70 %和 80 %的NBCA混合 ,测定不同浓度NBCA在离体新鲜动脉血中的凝固时间 ;②对 1例AVM和 1例AVF的 5支供血动脉行超选择性栓塞治疗。结果 ①不同浓度NBCA与离体新鲜动脉血凝固时间之间存在着指数函数关系、T(凝 ) =e1.9994-4.187D;②AVM栓塞术后畸形血管团闭塞约 90 % ,AVF栓塞术后瘘口基本被封闭。结论 A V循环时间与NBCA配比浓度之间存在指数函数关系 。

Objective By analysing the relation between the proportion of NBCA and the arteriovenous circulation time will give the optimal proportion of NBCA for embolizing cerebral AVM with microcatheter clinically.Methods (1) The fresh aterial blood fractions from intracranial hemorrhage in vitro of 16 cases were mixed with the 20%、33%、50%、70% and 80% NBCA respectively and evaluated the coagulation times with the different densities of NBCA in the fresh aterial blood in vitro; (2) two cases were performed with superselective embolotherapy to five feeding arteri. Results (1) the correlation index between different densities of NBCA and the fresh areterial blood in vitro , T (c) =e 1.9994-1.487D , (2) about 90% nidus of AVM were occluded after embolization, and the fistulas of AVF were basically closed after embolization.Conclusions There is a mathematical model between the arteriovenous circulation time and the proportion of NBCA, thus providing the theoretical clinical application of the embolotherapy of CAVM with microcatheter.