新型液态栓塞剂栓塞脑动静脉畸形70例经验总结  

Clinical experience of 70 cases of cerebral arteriovenous malformations embolization with Onyx~,a novel fiquid embofic agent

作　　者：宋冬雷[1] 冷冰[1] 徐斌[1] 王启弘[1] 陈衔城[1] 周良辅[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《中华外科杂志》2007年第4期223-225,共3页Chinese Journal of Surgery

摘　　要：目的介绍新型液态栓塞剂(Onyx)栓塞脑动静脉畸形的临床疗效和应用体会。方法本组共70例患者,均采用 SeIdinger 技术在股动脉内置入6F 鞘,6F导引导管进入颈内动脉或椎动脉,微导管超选择进入畸形团内,采用"阻断和前推技术"长时间缓慢注射 Onyx 栓塞脑动静脉畸形。结果 13例(18.6%)患者达到影像学完全栓塞,半年时随访造影5例无复发;38例(54.3%)患者达到大部或次全栓塞;19例(27.1%)为部分栓塞。4例患者因术中脑出血行急诊手术治疗,其中2例术后有肢体偏瘫,1例死亡;1例中央前回巨大动静脉畸形患者术后肢体偏瘫加重,2例患者术后出现视野缺损。结论 Onyx 可提高脑动静脉畸形的栓塞效果,但应积累经验预防和减少并发症。Objective To report our clinical experience of using Onyx, a new liquid embolic agent, to treat cerebral arteriovenous malformations （AVMs） as well as its efficacy. Methods Seventy cases were placed with 6F sheath in the femoral artery after Seldinger puncture and 6F guiding catheter was introduced into the internal carotid artery or vertebral artery, then a microcatheter was navigated into the nidus of AVMs. Slow injection of Onyx under fluoroscopic control was performed to embolize cerebral AVMs using the ＂plug and push＂ technique. Results Thirteen AVM cases （ 18.6% ） were totally occluded by Onyx and 5 cases of which didn＇t recurrence at 6-month after operation. Thirty-eight cases （54. 3% ） were subtotally occluded, while another 19 cases （27. 1% ） were partially embolized. Severe cerebral hemorrhage occurred in 4 cases, 2 of which had mild to severe hemiplegia after operation, and one died. Mild hemiplegia was also found in 1 case due to functional area embolization, and visual field deficit in 2 cases. Conclusions Onyx has unique and distinctive superiority in treating cerebral AVMs. Nonetheless, the correct embolization technique should be learned to achieve good clinical results and avoid complications.

关 键 词：颅内动静脉畸形 栓塞 治疗性 Onyx栓塞剂 

分 类 号：R743.4[医药卫生—神经病学与精神病学]