NBCA和ONYX栓塞治疗不同类型脑动静脉畸形的对比研究

目的对比分析NBCA和ONYX两种液态栓塞系统对不同类型脑动静脉畸形（AVM）的栓塞率，对NBCA和ONYX的有效性作出评价。方法选取1998年1月至2005年6月经过NBCA和ONYX栓塞治疗的50例脑AVM病人，NBCA组30例，ONYX组20例。男32例，女18例，平均33．5岁。对两组间不同大小、供血动脉类型、供血动脉支数脑AVM的栓塞率对比分析。全部数据采用秩和检验，应用SAS 6．12统计软件分析。结果对中型、皮质多支供血和浅部引流的脑AVM，ONYX的栓塞率高于NBCA。两者对小型、单支供血的脑AVM均有较高的栓塞率。结论对中型、皮质动脉多支供血的脑AVM，ONYX栓塞率比NBCA高。对大型和混合供血的脑AVM，NBCA与ONYX两者的栓塞率并无统计学意义。对于小型脑AVM，两种栓塞剂均有着较好的栓塞率。穿支供血的脑AVM不适合经动脉行血管内栓塞。对于体积较大的伴有广泛供血和位于功能区的AVM，可以分次栓塞，并结合手术和立体定向放射治疗。

The study of different type of cerebral arteriovenous malformation embolization with NBCA and ONYX

Objective To determine the effectiveness of arteriovenous malformation ( AVM ) embolization with N-butyl cyanoacrylate (NBCA) and ONYX. Methods All embolization procedures were performed using NBCA and ONYX. One group (30 patients) received embolization with NBCA and the other (20 patients) using ONYX, including 32 male and 18 female between January 1998 and Jun 2005. The mean age is 33.5 years. To study different clinical outcome of the tow groups, according to different size, type of supplying arteries, number of supplying arteries. All the data were analyzed using Ridit-test, and figures were made with SAS 6. 12. Results For middle size, cortex feeders, many feeders the rate of cerebral AVM's embolization with ONYX are higher than with NBCA(P =0.0000). For NBCA and ONYX, small AVM with fewer supplying arteries is more likely to be embolized completely. Conclusions The rate of cerebral AVM's embolization with ONYX are higher than NBCA in middle size, cortex feeders, many feeders. Some AVMs with very small supplying arteries are not suitable for embolization. Large basal ganglia or central parietal region's AVM should be treated by embolization, surgery and radiosurgery.