经脑膜中动脉入路Onyx栓塞前颅窝底硬脑膜动静脉瘘的疗效分析  

Efficacy analysis of Onyx embolization of anterior cranial fossa dural arteriovenous fistula via middle meningeal artery approach

作　　者：陈圣攀 张波[3] 叶明[1] 李静伟[1] 张鹏[1] 李萌[1] 张鸿祺[1] 凌锋[1] 

机构地区：[1]首都医科大学宣武医院神经外科,北京100053 [2]潍坊医学院临床学院 [3]潍坊医学院附属医院神经外科

出　　处：《中国脑血管病杂志》2016年第1期29-33,共5页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨经脑膜中动脉入路使用Onyx栓塞前颅窝底硬脑膜动静脉瘘（DAVF）的安全性和有效性。方法回顾性分析2013年1月至2015年10月首都医科大学宣武医院神经外科经脑膜中动脉入路使用Onyx栓塞治疗的7例前颅窝底DAVF患者的临床及影像学资料。结果 7例经脑膜中动脉入路栓塞的前颅窝底DAVF患者,术后即刻造影显示均获得一次性完全栓塞,影像学达到完全治愈,瘘口及引流静脉全部消失。患者术中、术后均未出现血管痉挛及破裂出血或神经功能障碍等并发症。患者出院前临床症状均明显好转。术后3~12个月的随访造影显示,瘘口完全栓塞无复发,临床症状全部治愈。结论经脑膜中动脉入路使用Onyx栓塞前颅窝底DAVF是一种安全、有效和首选的治疗方法,具有治愈率高和并发症少的特点。Objective To investigate the safety and effectiveness of Onyx embolization of anterior cranial fossa dural arteriovenous fistula（ DAVF） via middle meningeal artery approach. Methods From January 2013 to October 2015,the clinical and imaging data of 7 patients with anterior cranial fossa DAVF treated with Onyx embolization via middle meningeal artery approach at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively. Results Seven patients with anterior cranial fossa DAVF were embolized via middle meningeal artery approach,and the postoperative immediate angiography revealed that all achieved disposable complete embolization,imaging achieved complete cure,and the fistulae and draining veins disappeared completely. The patients did not have intraoperative and postoperative complications such as vasospasm,rupture or neurological dysfunction. The clinical symptoms of the patients were improved significantly before discharge. The follow-up angiography at3-12 months after procedure revealed that the fistulae were embolized completely without recurrence. The clinical symptoms of the patients were all cured. Conclusion Using Onyx for embolization of anterior cranial fossa DAVF via middle meningeal artery approach is a safe,effective,and preferred treatment method.It has the characteristics of high cure rate and fewer complications.

关 键 词：栓塞 ONYX 脑膜中动脉 硬脑膜动静脉瘘 前颅窝底 

分 类 号：R651.12[医药卫生—外科学]