硬脑膜动静脉瘘的综合治疗探讨

目的:探讨不同部位、不同类型的硬脑膜动静脉瘘的治疗方法.材料和方法:对29例经全脑数字减影血管造影(DSA)诊断为硬脑膜动静脉瘘患者采用血管内栓塞、手术夹闭瘘口-瘘口端引流静脉或静脉窦以及瘘口所在的静脉窦内支架置入等方法治疗.结果:29例硬脑膜动静脉瘘患者中,15例术后动静脉瘘完全闭塞,14例大部分闭塞;15例临床症状消失,余14例症状明显改善.无并发症发生.结论:硬脑膜动静脉瘘治疗的关键在于闭塞瘘口.根据其动静脉瘘的部位、供血动脉及瘘口的数量、引流静脉的特点等综合考虑是治疗成功的关键.

The Discussion about General Treatment for Dural Arteriovenous Fistula

Purpose: To discuss the method of treatment for different type of dural arteriovenous fistula in different position.Materials and Methods: In the group all the cases were diagnosed by digital subtraction angiogrophy(DSA) and performed treatment by the way of endovascular embolizition,surgical operation to clip the entrance of fistula-draining vein or sinus,implantation of stent in the sinus where the fistula was.Results: After operation the fistulas were completely occluded in 15 cases,and mostly occluded in 14 cases.Of those with clinic symptoms,the symptoms were disappeared in 15 cases and it was obviously improved in 14 cases.No complication occurred in the group.Conclusion: The keys to treat dural arteriovenous fistula were to occlude the fistula.The scheme of treatment should be considered on the basis of the place,the amount of feeding arteries,the amount of entrance of fistulas and the characteristic of the draining vein.