血管内栓塞治疗脑动静脉畸形的临床研究

目的 探讨α－氰基丙烯酸正丁酯（NBCA）生物胶血管内栓塞治疗脑动静脉畸形的效果及技术要点。方法 对469例脑动静脉畸形应用微导管技术,在数字减影血管造影监视下行血管内栓塞治疗。结果 成功栓塞469例脑动静脉畸形,467例痊愈,2例死亡。469例病人共行1108次栓塞,栓塞次数1－8次／例,平均2．3次。栓塞程度：100％栓塞155例,90％－100％栓塞93例,80％－90％栓塞105例,70％－80％栓塞78例,60％－70％栓塞27例,栓塞60％以下11例。栓塞后行γ-刀（或X－刀）放射治疗117例、手术切除32例。并发症有脑梗死1例,于尿激酶溶栓后恢复,脑出血4例,2例导管断裂滞留畸形团内。结论 血管内栓塞治疗脑动静脉畸形是一种安全、可靠、有效的治疗手段。

Endovascular embolization of cerebral arteriovenous malformation

OBJECTIVE: To evaluate the effect of endovascular embolization with alpha-NBCA on cerebral arteriovenous malformation with NBCA and emphasize the mainpoint of the embolizing technique. METHODS: 469 patients with cerebral arteriovenous malformation underwent endovascular embolization with alpha-NBCA by using microcatheter under digital subtraction angiography. RESULTS: 469 patients were treated successfully, 467 cases recovered clinically, 2 patients died. 469 patients underwent embolization therapy 1 108 times, ranging 1 to 8 times with an average of 2.3 times. 100% embolization was achieved in 155 cases, 90% approximately 100% in 93, 80% approximately 90% in 105, 70% approximately 80% in 78, 60% approximately 70% in 27, below 60% in 11. Nineteen cases received gamma-knife (or X-knife) therapy alone. 117 cases received gamma-knife (or X-knife) therapy after embolization, 32 cases received operations. Six cases suffered from different complications: 1 case with cerebral infarction recovered after urokinase injection, 4 cases suffered from intracranial hemorrhage, and 1 suffered from catheter resorting in nidus. CONCLUSION: Endovascular embolization is a safe, reliable and effective treatment for cerebral arteriovenous malformation.