球囊辅助介入栓塞硬脑膜动静脉瘘  

Balloon- assisted endovascular treatment of intracranial dural arteriovenous fistulas

作　　者：霍晓川[1] 罗俊生[2] 姜除寒[1] 李佑祥[1] 杨新建[1] 吴中学[1] 

机构地区：[1]北京市神经外科研究所,100050 [2]辽宁医学院

出　　处：《中华神经外科杂志》2013年第2期178-181,共4页Chinese Journal of Neurosurgery

基　　金：辽宁省高等学校优秀科技人才支持计划（LRZOIIOZ4）

摘　　要：目的应用球囊辅助Onyx胶介入栓塞硬脑膜动静脉瘘，分析球囊辅助栓塞的意义和效果。方法回顾性分析6例球囊辅助Onyx胶介入栓塞的硬脑膜动静脉瘘患者，总结临床表现，血管造影特点，血管内治疗方案及临床疗效。结果6例患者中4例表现为皮层静脉返流。在球囊辅助下，5例经动脉入路栓塞，1例经静脉入路栓塞。4例患者球囊用于保护颈内动脉，1例用于保护椎动脉，1例用于脑膜中动脉防止Onyx胶返流并降低瘘口流速。术后血管造影示4例完全栓塞，2例部分栓塞。1例出现栓塞相关的暂时性面神经麻痹。结论应用球囊辅助Onyx胶介入栓塞治疗颈内颈外动脉共同供血的硬脑膜动静脉瘘，能够有效地保护颅内动脉。在供血动脉中充盈球囊能够有效防止Onyx胶返流并降低瘘口流速。Objective To report experiences in balloon - assisted endovascular Onyx embolization of intracranial dural arteriovenous fistulas （ DAVFs ）. Methods Clinical records of 6 DAVFs patients treated with balloon -assisted endovascular Onyx embolization were retrospectively collected to analyze their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes. Results Four patients were presented with cortical venous reflux. Five patients underwent transarterial and one patient underwent transvenous Onyx embolization adjunct to transarterial balloon protection. The balloons were use to protect ICA in 4 patients, to protect VA in 1 patient, and to prevent Onyx reflux in MMA in 1 patient. Angiograms obtained immediately after embolization demonstrated complete transarterial obliteration of the fistula in 4 patients and partial occlusion in 2. One patient had Onyx embolization - relatted complication of transient hemi - facial hypoesthesia. Conclusions Balloon adjunct to Onyx embolization can provide protection of the intracranial artery in the treatment of intracranial DAVFs with double blood supply from intracranial and extracranial arteries. Balloons could prevent Onyx reflux and decrease the flow rate of fistula when placed into the blood supply artery.

关 键 词：硬脑膜动静脉瘘 栓塞 球囊 ONYX胶 

分 类 号：R743[医药卫生—神经病学与精神病学]