颈外动脉供血型硬膜动静脉瘘的经血管治疗

目的：评估经动脉颗粒栓塞颈外动脉供血型硬膜动静脉瘘的应用技术和临床效果。材料和方法：１０例经血管造影证实的硬膜动静脉瘘患者，选择性插管入近病巢处的供养动脉或近供养动脉开口的主干动脉，在电视严密监视下缓慢注入ＰＶＡ颗粒直至血流静止、瘘道闭塞。术后１５分钟和６个月随访血管造影及评估临床情况。结果：７例术后瘘道完全闭塞，３例大部闭塞（８０％发以上），６个月后随访血管造影者７例，均未显示瘘道。结论：经动脉采用颗粒栓塞颈外动脉供血型硬膜动静脉瘘，其操作简便，较为安全，临床效果好，应视为此类疾病的首选治疗方法。

Endovascular Therapy in Dural Arterio-venous Fistulas Supplied from External Carotid Arteries

Purpose:To evaluate the efficacy and safety of endovascular therapy in intracranial dural arterio-venous fistulas supplied with external carotid arteries(ecaDAVFs).Materials and Methods:Ten patients angiographically proven as DAVFs either ipsilaterally or bilaterally were embolized with particles(PVA).In all 10 patients the catheters were positioned closely to the orifices of the DAVFs nidus or to the parent arteries near the opening of the feeding arteries.Under fluoroscopic control the particles were slowly injected with 2ml syringe manually until the fistulas were blocked.Angiography and clincal evaluation were performed in 15 minutes and six months after the embolization procedure.Results:Postembolization angiographies showed complete disappearance of DAVFs in 7 patients and incomplete(occlusion>80%)in 3 patients.In 7 patients the follow-up angiographies demonstrated complete blockage of fistulas six months after the procedures.Conclusion:Particles were considered as an ideal embolization material for transarterial embolization in ecaDAVFs and the procedure is a quite simple,safe,with better clinical efficacy method which should be the first-choice modarity for ecaDAVFs.