以动静脉瘘为主的脑动静脉畸形的栓塞治疗

目的探讨以动静脉瘘为主的高血流量脑动静脉畸形(AVM)的血管内栓塞治疗方法.方法将Spinnaker-1.5F微导管送至AVM近动静脉瘘口处,超选择造影测量动静脉微循环时间,先用液态弹簧圈2～3枚经微导管作初步填塞以减慢血流,再根据不同微循环时间配制不同浓度NBCA胶(17%～33%)栓塞AVM.结果采用液态弹簧圈和NBCA胶联合栓塞13例以动静脉瘘为主的AVM,完全栓塞3例,90%栓塞5例,60%栓塞3例,40%栓塞2例,无一例出现并发症.结论采用液态弹簧圈联合NBCA胶能安全、有效地治疗以动静脉瘘为主的脑动静脉畸形.

Endovascular embolization for high-flow cerebral arteriovenous malformation

Objective To investigate a new treatment of embolization for high-flow cerebral arteriovenous malformation (AVM). Methods Spinnaker-1.5F micro-catheter was deployed to reach the proximity of the AVM fistula outlet. The AVM time was detected during superselective angiography. Firstly, 2 to 3 coins of liquid coils were used to preliminarily block the AVM to reduce the velocity of flow. Secondly, NBCA glue in different concentrations (17%-33%) was used to block the AVM according to the microcirculation time. Results 13 cases of cerebral high-flow cerebral AVMs were treated with the liquid coil and NBCA glue, 3 cases of them achieved complete embolism, while 5 cases with 90% embolism, 3 cases with 60% embolism, and 2 cases with 40% embolism. There was no complication. Conclusion The application of liquid coil associated with NBCA glue can effectively embolize the high-flow cerebral AVM.