Onyx动脉入路栓塞硬脑膜动静脉瘘(附8例报告)

<正>硬脑膜动静脉瘘(dural arteriovenous fistula,DAVF)为难治性脑血管疾病之一。血管内栓塞为主要治疗手段,早期经动脉栓塞,但因栓塞材料弥散性不良而使瘘口闭塞困难。其后推崇经静脉栓塞,但可致相应静脉窦结构及功能破坏。因而改善栓塞剂的弥散性,经动脉栓塞DAVF,可能有利于瘘口闭塞及避免相应静脉窦的破坏。Onyx胶为非粘附性液态栓塞剂,弥散能力良好。但Onyx用于DAVF的治疗,尚缺少足够的经验及报道。我们应用ONYX经动脉入路栓塞8例DAVF,效果良好,现报道如下。     

"篮筐"技术在颅内动脉瘤介入治疗中的应用

Objective To study the ways,mechanism,indication,curative effect of " Basket" skill applied in the interventional therapy for intracranial aneurysm. Methods Intracranial aneurysm with 1 : 1 ≥ neck/body ≥ 1 : 2 ," 3 D coil" was used to form a basket in it;in that with 1:2 > neck/body,common "2D coil" was applied. And the following coils were applied with hydrocoil or fibered coil combined with common platinum coil to increase the embol-ism density. Results In 156 cases with 158 aneurysms,143 aneurysms were 100% embolized (90. 5% ) ;131 ca-ses discharged with GOS 5 score(84.0% ),and 2 cases died ( 1.3% ). Conclusion " Basket" skill can increase the embolization density in aneurysm,reducing the residual of the neck,getting embolizated fully and improving the prognosis.     

颅内动脉瘤介入栓塞治疗后早期再破裂原因探讨及预防

目的探讨颅内动脉瘤血管内栓塞治疗后早期再破裂原因，以及相应的预防措施。方法对5例行颅内动脉瘤血管内栓塞治疗后早期再破裂患者临床资料进行回顾性分析。结果5例患者术后3d内先后发生动脉瘤再破裂出血，2例死亡，3例康复。结论术中假瘤过度填塞、术后抗凝过度、过早过频腰椎穿刺、动脉瘤残颈破裂为术后早期再破裂的主要原因。