术中DSA辅助手术切除脑动静脉畸形的安全性及有效性

目的 探讨术中DSA辅助显微手术切除脑动静脉畸形的安全性和有效性。方法 回顾性分析2017年1月至2020年12月术中DSA辅助下显微手术治疗的47例脑动静脉畸形的临床资料。结果 首次切除后术中DSA显示，畸形血管团完全切除10例，有残留37例。术中DSA次数中位数为2.0（2.0，3.5）次。26例采用动脉瘤夹定位畸形血管团位置，定位造影次数中位数为1.5（1.0，2.0）次。术后即刻造影显示畸形血管团完全切除44例，部分残留3例。5例术后出现手术相关并发症。术后随访1年，预后良好（mRS评分≤2分）46例，预后不良1例；DSA随访发现复发7例。结论 术中DSA辅助下手术切除脑动静脉畸形，有助于提高畸形团全切除率，减少手术并发症。

Safety and efficacy of microsurgical resection assisted by intraoperative DSA for patients with cerebral arterio-venous malformations

Objective To investigate the safety and effectiveness of microsurgery assisted by intraoperative DSA for patients with cerebral arteriovenous malformations (AVMs). Methods The clinical data of 47 patients with cerebral AVMs who were treated with microsurgery assisted by intraoperative DSA from January 2017 to December 2020 were retrospectively analyzed. Results After the first resection, intraoperative DSA showed no AVMs in 10 patients and residual AVMs in 37 patients. The median number of intraoperative DSA was 2.0 (IQR: 2.0~3.5) times. Aneurysm clips were used to locate the AVMs in 26 patients, and the median number of localization angiography was 1.5 ( IQR: 1.0~2.0) times. Immediate postoperative angiography showed complete resection of the AVMs in 44 patients and partial residual in 3. Operation-related complications occurred in 5 patients. The one-year follow-up showed a good prognosis (mRS score ≤2 points) in 46 patients, and a poor prognosis in 1. DSA showed recurrence in 7 patients. Conclusions For patients with cerebral AVMs undergoing microsurgery, intraoperative DSA is helpful to improving the total resection rate of AVMs and reducing the postoperative complications.