经静脉入路采用Onyx或联合弹簧圈治疗海绵窦区硬脑膜动静脉瘘的疗效

目的探讨经静脉入路采用Onyx或联合可脱性弹簧圈栓塞治疗海绵窦区硬脑膜动静脉瘘的安全性和有效性。方法回顾性分析2007年2月—2010年12月,经静脉入路栓塞治疗的12例海绵窦区硬脑膜动静脉瘘患者的临床资料,其中经岩下窦入路10例,经面静脉-眼上静脉入路2例。单独应用Onyx 8例,Onyx联合可脱性弹簧圈4例。结果①治疗后即刻血管造影显示完全闭塞10例,少量残留2例。单独应用Onyx栓塞治愈6例,好转2例,Onyx联合可脱性弹簧圈栓塞治愈2例,好转2例;总有效率100%,治愈率66.7%,无加重或死亡病例。②2例术中出现心动过缓,3例术后出现眶部疼痛。③对所有患者进行临床随访,随访时间为6～32个月,无复发及加重者。结论静脉入路Onyx或联合可脱性弹簧圈栓塞海绵窦区硬脑膜动静脉瘘的疗效确实,安全可靠。

Efficacy of transvenous embolization of cavernous sinus dural arteriovenous fistula with Onxy or in combination with detachable coils

Objective To investigate the safety and effectiveness of transvenous embolization of cavernous sinus dural arteriovenous fistula with Onxy or in combination with detachable coils.Methods Twelve patients with cavernous sinus dural arteriovenous fistula treated by transvenous embolization from February 2007 to December 2010 were analyzed retrospectively.Ten patients were treated via the inferior petrosal sinus approach,2 were treated via the vein-superior ophthalmic vein approach.Eight patients used Onyx alone,and 4 used Onxy in combination with detachable coils.Results ①Angiography showed complete occlusion in 10 patients immediately after treatment,small amount of residues remained in 2 patients.Six patients were cured with Onyx embolization alone,2 were improved,2 were cured with Onyx in combination with detachable coils embolization,and 2 were improved.The total effective rate was 100%,the total cure rate was 66.7%,and none of the patients worsened or died.②Two patients had intraoperative bradycardia,3 had postoperative orbital ache.③All patients received clinical follow-up for 6 to 32 months and no recurrent and worsened were found.Conclusion The clinical efficacy of transvenous embolization of cavernous sinus dural arteriovenous fistula with Onxy or in combination with detachable coils is effective and safe.