国产α-氰基丙烯酸正丁酯栓塞治疗脑动静脉畸形的临床研究

目的　本组报告用自行研制的胶体栓塞剂ａ氰基丙烯酸正丁酯（ＮＢＣＡ） 栓塞治疗脑动静脉畸形（ＡＶＭ） １０６ 例。方法　均经股动脉和同侧颈动脉入路， 使用ＮＢＣＡ 的方法有三种： 包括完全根据畸形血管团的动静脉循环时间配制不同比例的碘苯酯和ＮＢＣＡ混合液； 微螺旋圈和ＮＢＣＡ混合栓塞； 循环时间长于２ 秒时直接注入３０ ％ 的ＮＢＣＡ混合液。结果　单支供血的ＡＶＭ均在一次栓塞后完全消除； 多支供血的ＡＶＭ 在栓塞１ ～３ 次后畸形血管团消除范围从４０％ ～１００％ 不等。结论　国产ＮＢＣＡ在栓塞脑ＡＶＭ 的弥散性能良好， 聚合速度可控制， 是治疗脑ＡＶＭ 性能良好的栓塞材料。

The use of native N butyl cyanoacrylate for embolizing arteriovenous malformations of the brain.

Objective Using native N butyl cyanoacrylate(NBCA) for embolization of 106 cases with cerebral arteriovenous malformation.Methods Embolization for all cases via the approaches of femoral and ipsilateral carotid arteries, and the methods of using NBCA were composed of 3 types: (1)Mixed NBCA and myodil in different ratio depending on the circulation time from artery to vein within the nidus, (2)Mixed embolization with micro coil and NBCA.(3)Injecting 30% of NBCA when the circulation time was prolonged for longer 2 seconds.Results AVM with single feeders were totally eliminated after first embolization and eliminated 40% 100% in multifeeders after embolizing 1 3 times.Conclusion This NBCA is fairly easy to diffuse and the time of polymerization could be controled.So, it is a good native embolizing material for treating cerebral AVM.