共查询到16条相似文献,搜索用时 140 毫秒
1.
目的:探讨脑动静脉畸形( Cerebral arteriovenous malformation,AVM)合并动脉瘤治疗策略、治疗方法。方法:经全脑数字减影血管造影( Digital subtraction angiography DSA)检查确诊出血的10例患者,根据AVM血流动力学及动脉瘤特点,取不同栓塞策略,先栓塞动脉瘤后栓塞动静脉畸形。结果:畸形团内型5例,用Onyx胶、弹簧圈栓塞,单纯弹簧圈栓塞2例;与供血动脉相关型4例,与畸形团无关型1例,弹簧圈栓塞动脉瘤,再Onyx胶栓塞畸形血管。复查DSA,动脉瘤全部栓塞,AVM完全消失5例,3例栓塞80%,2例栓塞60%~80%,1例术后出现病变对例肢体轻度偏瘫。后期再次栓塞畸形血管团2例,行开颅切除畸形血管团1例,立体定向放射治疗2例。结论:动静脉畸形合并动脉瘤的血管内栓塞治疗可取得较好的效果,畸形团供血动脉瘤优先栓塞动脉瘤和载瘤动脉,畸形团内动脉瘤则以闭塞该部血流为主,如技术条件允许也尽量先栓塞带瘤血管巢。 相似文献
2.
目的探讨并总结液态栓塞剂Onyx治疗脑动静脉畸形(AVM)的应用和经验。方法 2006年1月~2008年1月应用液态栓塞剂Onyx成功治疗脑AVM42例,畸形团的直径小于3cm13例,3~6cm21例,大于6cm8例。结果 6例完全消失,13例达90%以上,20例达80%~90%,3例80%以下。并发症:2例有术后头痛,1例有血管团对侧远端肢体麻木,1例微导管遗留体内。结论 Onyx治疗脑动静脉畸形有很好的疗效,并发症少。 相似文献
3.
目的:探讨Onyx胶栓塞治疗脑动静脉畸形的临床价值及技术要点。方法:回顾性分析应用Onyx胶介入治疗AVM患者25例,总结其疗效、并发症及预后情况,评价Onyx胶应用于AVM介入治疗中的临床价值并总结其技术要点。结果:25例完全栓塞者13例,80%以上栓塞4例,50%~80%以上栓塞8例。术中1例微导丝刺破血管出血,术后1例单侧肢体偏瘫,均经治疗后逐渐恢复。随访6~12个月,未发现畸形血管团再通。结论:应用Onyx胶栓塞治疗AVM具有较大的优越性和良好的疗效;在应用过程中应熟练掌握其性能、适应证和栓塞技巧,从而提高治愈率,减少和避免并发症的发生。 相似文献
4.
5.
目的 探讨血管内治疗脑动静脉畸形(AVM)的临床意义。方法 在DSA电视屏幕监控下。通过微导管插管技术应用α-氰基丙烯酸正丁酯(NBCA)生物胶对33例脑AVM患者进行栓塞治疗。结果 血管内栓塞治疗33例,共栓塞55次。栓塞程度:栓塞100%10例,80%-100%13例。60%-80%7例。60%以下3例。栓塞治疗中出现脑血管痉挛5例。头痛加重7例。栓塞后行1刀放射治疗5例,手术切除治疗5例。随访无一例再出血和死亡。结论 血管内栓塞治疗脑AVM是一种安全有效的治疗方法。血管内栓塞结合手术切除或立体定向放射的综合应用是治疗脑AVM较好的方法。 相似文献
6.
7.
8.
探讨DSA的超选择造影显示的脑动静脉畸形(AVM)相关血管构筑学(AVM的大小、位置、供血动脉)以及血管内栓塞治疗与癫痫发作的关系,以期预测脑动静脉畸形癫痫发作的危险性及栓塞治疗癫痫的有效性。 方法:通过DSA超选择造影显示95例脑动静脉畸形的血管构筑学特点;所有脑AVM应用NBCA或ONYX栓塞治疗;统计学分析采用χ2检验。结果:脑动静脉畸形癫痫发作与AVM的大小、位置有统计学意义(P均<0.01),与供血动脉支数无统计学意义(P>0.05);本组95例患者中43例有癫痫发作,占45%,术后20例症状消失,11例明显减轻,有效率72.1%。结论:AVM越大、位置越近皮层越易发生癫痫,供血动脉支数的多少与癫痫的发作无关;血管内栓塞AVM治疗由其产生的癫痫效果较好。 相似文献
9.
目的 探讨各种类型脑动静脉畸形(AVM)治疗方法的选择为临床治疗提供依据。方法 对36例脑AVM临床治疗进行回顾性分析,并结合文献复习。结果 36例脑AVM病人,手术切除9例和血管内栓塞后手术切除2例畸形血管团消失,γ-刀治疗4例,复查血管团消失或染色变淡,血管内栓塞10例和血管内栓塞后γ-刀治疗11例中栓塞〉95%4例,〉80%7例,〉50%8例。复查GOS预后分级5级25例(69.4%);4级7例(19,4%),其中后遗头痛3例,癫痫4例;3级3例(8.3%)后遗神经功能缺失,主要为偏瘫、失语等;死亡1例(2.8%)。结论 根据脑AVM的Spetzler-Martin分级和临床类型选择合理的治疗方法可减少致残率和病死率。 相似文献
10.
目的 探讨脑动静脉畸形 (AVM)的血管内栓塞治疗及综合治疗。方法 应用血管内栓塞治疗脑AVM 6 3例 ,栓塞剂为二氰基丙烯酸正丁酯 (NBCA) ,栓塞后 10例行手术切除 ,36例行γ -刀治疗。结果 6例完全栓塞 ,30例栓塞 70 %~ 90 % ,2 3例栓塞 5 0 %~ 70 % ,4例栓塞小于 5 0 %。结论 血管内栓塞治疗脑AVM的方法安全性好、损伤小 ,栓塞深部供血动脉可降低手术的风险 ,并可减少AVM体积使之适合放射治疗。血管内栓塞治疗是AVM综合治疗的重要组成部分。 相似文献
11.
应用新型液体栓塞剂Onyx18治疗脑动静脉畸形 总被引:3,自引:0,他引:3
目的:探讨新型液体栓塞剂Onyx18在脑动静脉畸形血管内治疗的应用价值及技术要点。方法:采用Onyx18栓塞5例脑动静脉畸形,畸形血管团<3cm1例,3~6cm3例,>6cm1例;Spetzler-Martin分级:II级1例,III级2例,IV级2例。结果:2例完全栓塞,1例获90%栓塞,2例获75%栓塞。结论:较NBCA相比,Onyx18是治疗脑动静脉畸形较为理想的栓塞材料,需要掌握栓塞的技巧,减少并发症的发生,但是其长期疗效有待随访结果的验证。 相似文献
12.
13.
Endovascular treatment of cerebral arteriovenous malformations with Onyx embolization 总被引:6,自引:1,他引:5
Background In the past 5 years, new treatment materials and techniques offering a different concept in endovascular treatment have been described for cerebral arteriovenous malformations (CAVMs). The aim of this study was to assess the endovascular treatment of CAVMs by using a liquid embolic material, Onyx ( Micro Therapeutics. Inc. , Irvine, CA, USA).
Methods From September 2003 to September 2004, Onyx was used to treat 22 patients with CAVMs. Ten AVMS were located in functional areas, 8 in deep cerebral areas, and 4 in the cerebellar hemisphere. The size of CAVMs was about 3 cm in diameter in 5 patients, 3 -6 cm in 11, and more than 6 cm in 6.
Results In the 22 patients, Onyx embolization was successful. Nidus occlusion was complete in 3 patients, 〉 90% in 8, 〉 80% and 〈 90% in 6, and 〉 50% and 〈 80% in 5. Complications included transient neurological deficits in 2 patients, and adherence of microcatheter to the site of injection in 2.
Conclusions Being non-adhesiveness, Onyx is a safe and satisfactory embolic material in the treatment of CAVMs. But its long-term efficacy awaits further follow-up. 相似文献
14.
15.
GAO Kun YANG Xin-jian MU Shi-qing LI You-xiang ZHANG You-ping L Ming WU Zhong-xue 《中华医学杂志(英文版)》2009,122(16):1851-1856
Background Endovascular therapy plays an important role in the treatment of brain arteriovenous malformations (BAVMs). Ethylene vinyl alcohol copolymer (Onyx) is a novel liquid embolic material. This study aimed to summarize our experience of using Onyx for embolization of BAVMs with the focus on embolization technique. Methods From September 2003 to November 2007, 115 patients (43 women and 72 men, with a mean age of 29 years) with BAVMs were endovascularly treated with Onyx in our department. The following features of all AVMs were evaluated prior to treatment: type of nidus and shunt, draining veins, and feeding arteries. A total of 196 endovascular procedures were performed. Results The course of endovascular treatment was completed in 88 patients. Additional sessions were planned in 27 patients. Of the 88 patients, total occlusion was obtained in 23 patients (26.1%), near-total (〉80% of the original volume) occlusion was obtained in 35 patients (39.8%) and partial occlusion (〈80% of the original volume) was obtained in 30 patients (34.1%) using embolization as the sole therapeutic technique. Mean volume reduction was 72% (range 30%-100%) in 115 patients. Thirty four patients (38.6%, 34/88) underwent radiosurgical treatment. Additional embolization sessions were planned in 27 patients. Complications occurred in 19 patients (16.5%, 19/115), leading to death in one patient (mortality 0.9%) and permanent disabling in 3 patients (morbidity 2.6%). Conclusions Onyx was shown to be feasible and safe for embolization of BAVMs. Proper use of the Onyx injection technique largely improved the endovascular treatment of BAVMs. Large AVMs can be adequately reduced in size through the use of additional treatment. 相似文献
16.
目的 研究Onyx液体栓塞剂栓塞治疗脑动静脉畸形的临床效果.方法 回顾性收集2010年1月~2013年4月我院应用Onyx液体栓塞剂栓塞治疗脑动静脉畸形的30例病例临床资料,研究其短中期的临床效果.结果 脑动静脉畸形闭塞率为30%~50%共5例(20%),50%~80%共15例(60%),>80%共5例(20%);对不同分析下的栓塞情况进行比较分析发现,Ⅰ~Ⅱ组与Ⅲ~Ⅴ组的患者在栓塞效果上并无明显的统计学差异(x2=1.231,P=0.54).结论 Onyx可提高脑动静脉畸形的栓塞效果,但长期效果需进一步随访. 相似文献