Glubran-2胶用于栓塞治疗硬脊膜动静脉瘘

目的 观察以Glubran-2胶栓塞治疗硬脊膜动静脉瘘(SDAVF)的效果。方法 回顾性分析19例接受Glubran-2胶栓塞治疗的SDAVF患者,观察治疗后即刻栓塞效果、3个月后MRI表现、6个月后数字减影血管造影(DSA)表现及改良Aminoff-Logue评分,并根据后者评估疗效为稳定、改善或加重。结果 治疗后即刻造影示19例瘘口均完全封闭。治疗后1个月1例再次出现下肢无力和排尿困难,脊髓血管造影示瘘口复发,转外科治疗后病情稳定;治疗后3个月复查MRI示18例脊髓水肿范围均较治疗前明显缩小、血管流空影消失;治疗后6个月复查脊髓动脉DSA,18例均未见瘘口复发;改良Aminoff-Logue评分4.5(1.8,8.0),与治疗前7.5(3.8,9.0)]差异有统计学意义(Z=－3.16,P<0.05),评定疗效为4例稳定、13例改善及1例加重。随访期间未见严重并发症。结论 Glubran-2胶用于栓塞治疗SDAVF效果较好。

Embolization of spinal dural arteriovenous fistula with Glubran-2 glue

Objective To observe the effect of embolization of spinal dural arteriovenous fistula (SDAVF) with Glubran-2 glue. Methods Data of 19 patients who underwent embolization of SDAVF with Glubran-2 glue were retrospectively analyzed. The immediate embolization effect, MRI findings 3 months after embolization, also digital subtraction angiography (DSA) findings and modified Aminoff-Logue score 6 months after embolization were observed. The therapeutic effects were evaluated based on modified Aminoff-Logue score and classified as stable, improved or aggravated. Results Immediately after treatment, the fistula was completely embolized in all 19 cases. One patient experienced lower limb weakness and difficulty urinating again 1 month after treatment, and spinal cord angiography showed recurrence of fistula, then surgical treatment was performed, and the postoperative condition was stable. Three months after treatment, MRI showed significant reduction of the extent of spinal cord edema compared to before treatment in 18 cases, and the vascular flow void disappeared. Six months after treatment, DSA showed no recurrence of fistula, and the modified Aminoff-Logue score was 4.5 (1.8, 8.0), being significant different with that before treatment (7.5 3.8, 9.0]) (Z=-3.16, P<0.05), and the lesions were stable in 4 cases, improved in 13 cases and aggravated in 1 case. No serious complication occurred during the follow-up period. Conclusion Embolization of SDAVF with Glubran-2 glue had good therapeutic effect.