11例非Galen静脉脑动静脉瘘的血管内栓塞治疗

作者报告了1979年至1995年治疗的11例非Galen静脉的脑动静脉瘘(AVF),对其诊断标准及治疗原则进行探讨.1例以球囊栓塞失败后行手术夹闭供血动脉;8例以IBCA/NBCA栓塞治疗,其中1例经3次栓塞缩小静脉球后手术切除残留的动静脉畸形(AVM);2例以弹簧圈栓塞瘘口.结果:动静脉瘘100%闭塞8例,恢复良好.8例中的6例脑血管造影复查,未见复发;植物生存1例;死亡2例.对治疗原则,血管内栓塞进行了讨论,认为栓塞材料首选弹簧圈.

The diagnosis and treatment of non-galenic cerebral arteriovenous fistulas

Since 1979, 11 cases of nongalenic cerebral AVFs had been treated in this center. The patients consist of 4 males and 7 females, aged from 22 months to 35 years > with an averge of 12 years. Presentation; 4 mass effect, 3 epilepsy, 5 intracranial hemorrhage. All of them were diagnosed by DSA cerebral angiography. Treatment: 8 cases underwent IBCA or NBCA embolization(one underwent surgical resection of the residual fistula and AVM after 3 times of embolization). One case underwent surgical clipping of the feeding artery after a failed balloon embolization. Two cases underwent coil embolization (one residual AVM underwent NBCA embolization). Results; Eight patients achieved 100% obliteration of the AVF (one residualAVM was cured by X-knife therapy 4 months later), one vegetatively survived and two died. Six of the eight improved cases being follow-up by angiography 10 days to 5 months later, no re-canalization occurred. The result suggests that endovascular therapy is an effective measure in treating nongalenic cerebral AVFs, and coil em-bolization would be the first choice.