Onyx-18和(或)弹簧圈栓塞治疗海绵窦区硬脑膜动静脉瘘(附17例报道)  

Endovascular Embolization of Cavernous Sinus Dural Arteriovenous Fistula with Onyx-18 and(or) Coils(17 Case Reports)

作　　者：王涛[1] 李文纲[1] 李士其[2] 徐立权[1] 

机构地区：[1]复旦大学附属上海市第五人民医院神经外科 [2]复旦大学附属华山医院神经外科

出　　处：《中国临床神经科学》2016年第3期332-335,共4页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨Onyx-18和(或)弹簧圈血管内栓塞治疗海绵窦区硬脑膜动静脉瘘(DAVF)的安全性和有效性。方法回顾性分析17例经Onyx-18和(或)弹簧圈血管内栓塞的海绵窦区DAVF患者的临床疗效及随访资料,栓塞治疗方式选择Onyx-18和(或)弹簧圈,单用经静脉途径治疗或单用经动脉途径治疗或经静脉+动脉联合途径治疗。结果 17例海绵窦区DAVF患者中,11例治愈,6例改善。单用经静脉途径治疗10例,治愈率为70%(7/10例);单用经动脉途径治疗3例,治愈率33.3%(1/3例);经静脉+动脉途径联合治疗4例,治愈率75%(3/4例)。所有经治病例均无严重致残和致死并发症。结论海绵窦区DAVF的血管内治疗应建立在正确认识该部位DAVF解剖特点的基础上。Onyx-18和(或)弹簧圈栓塞治疗海绵窦区DAVF是安全有效的方法。经静脉途径治疗及联合经静脉+动脉途径治疗优于单纯经动脉途径治疗。Aim To investigate the efficacy and safety of endovascular embolization of carvernous sinus dural arteriovenous fistula with Onyx-18 and（or） coils.Methods From March 2006 to August 2015 in our center,17 cases of cavernous sinus DAVF were treated with Onyx-18 and（or） coils.The patients were treated via venous or artery approach or combined approach.Results Among the 17 cases,11 cases were treated successfully and cured in one session.Another 6 cases were basically cured with symptoms improved.Cure rate in transvenous（TVE） approach was 70% compared with 25% in transarterial（TAE） approach.Cure rate in transvenous combined with transarterial（TVE＋TAE） approach was 75%.There were no lethal complications.Conclusion Endovascular emboliztion tragedy could cure carvernous sinus dural arteriovenous fistulas.The method is safe and effective.Embolization via TVE and（TVE＋TAE） approach tended to be superior to that via TAE approach.

关 键 词：海绵窦区硬脑膜动静脉瘘 血管内治疗 栓塞 

分 类 号：R651.12[医药卫生—外科学]