血管内治疗非Galen静脉脑动静脉瘘

目的探讨血管内栓塞治疗非Galen静脉脑动静脉瘘（NCAVF）的效果。方法2009年4月至2012年1月收治13例NCAVF,其中6例为单瘘口,7例为多瘘口;采用球囊辅助Glubran胶栓塞4例,弹簧圈辅助Glubran胶栓塞7例,单纯使用Glubran胶栓塞剂栓塞2例。结果术后即刻造影示,8例一次完全栓塞瘘口;3例分两次完全栓塞瘘口,1例分三次完全栓塞瘘口,1例三次栓塞后仍有部分瘘口残留。术后随访3个月~2年,12例复查DSA示11例瘘口完全栓塞,1例多瘘口大部分栓塞,但症状明显缓解;1例小儿患者,家属拒绝复查DSA,术后1年无明显临床症状。结论应用Glubran胶栓塞治疗NCAVF可以直接准确地堵塞瘘口,恢复正常的脑血液循环;在高流量瘘口栓塞中,使用球囊或弹簧圈辅助可以降低瘘口的血流速度,有利于栓塞瘘口。

Endovascular treatment of nongalenic cerebral arteriovenous fistula

ObjectiveTo explore the effectiveness of embolization using glubran in treating nongalenic cerebral arteriovenous fistula（AVF）.MethodsThe clinical data of 13 patients with nongalenic cerebral AVF who underwent emboliztaion using glubran from April 2009 to November 2012 were analyzed retrospectively.The follow-up time ranged from 3 months to 24 months.ResultsOf 13patients with nongalenic cerebral AVF,4 patients were embolized with balloon-assisted glubran,7 with coil-assisted glubran and 2 with glubran alone.The DSA images obtained immediately after embolization showed that complete occlusion of ANFs was achieved in 12patients and patial in 1.All symptoms resolved after embolization.No patient recurred during the follow-up period.Conclusions Embolization with glubran is a feasible and efficient treatment method for patients with nongalenic cerebral AVF.Using balloons and coils helps to reduce the velocity of blood flow and helps glubran to embolize the fistulas in patients with high-flow AVF.