脑动静脉畸形出血相关的血管构筑因素研究

目的通过对脑动静脉畸形（AVM）DSA造影特点与出血因素的研究，为判断出血的危险性及为临床选择治疗方案提供依据。方法对我院行血管内栓塞治疗脑AVM80例（其中颅内出血49例）进行分析，了解脑AVM畸形团的大小、部位、供血动脉的类型、引流静脉数目及路径、AVM合并动脉瘤等因素与脑出血的关系。结果脑AVM中、小型畸形团出血危险性高于大型；脑深部基底节和后颅凹的AVM出血的危险性比大脑皮层的AVM大；脑穿支供血动脉和椎动脉供血的AVM出血危险性大；脑AVM引流静脉数越少出血的危险性越高，而引流静脉路径与出血无明显关系；脑AVM合并动脉瘤易出血。结论脑AVM出血与血管构筑因素有关，根据血管不同构筑因素，判断脑AVM出血的可能性，为血管内栓塞治疗提供指导。

The study of angioarchitecture on cerebral arteriovenous malformation bleeding

Objective To study the relationship between the characteristics of DSA and factors of bleeding on cerebral arteriovenous malformation (AVM) , to judge the risk of bleeding and provide clinical therapeutic program. Methods 80 AVM cases of intravascular therapy were analysed to determine the relationship between brain bleeding and cerebral AVM factor on the site and size of masses, the type of supplying arteries, the number and pathway of venous drainage and the following aneurysms. Results The risk of brain bleeding of the medium and mini-sized masses is higher than that of maximus masses. The danger of brain bleeding of AVM located at basal ganglion or subtentorium part is higher than that of cerebral cortex. The AVM of brain perforating branches or vertebral artery supplying arteries is easy to bleed. The AVM of fewer venous drainage or following aneurysms is inclined to bleed. But the danger of cerebral AVM bleeding is irrelevant to the pathway of venous drainage. Conclusions Cerebral AVM bleeding is relevant to angioarchitecture. According to various angioarchitecture, we can judge the possibility of cerebral AVM bleeding and provide intravascular therapeutic program.