非Galen型脑动静脉瘘6例血管内介入栓塞治疗体会  

The treatment experience of endovascular interventional embolization on nongalenic cerebral arteriovenous fistula

作　　者：付增彬 赵亚鹏[1] 李普阳[1] 王召[1] 高雪亮[1] 贾培雷[1] 张楠[1] 王凯 程建业[1] FU Zengbin;ZHAO Yapeng;LI Puyang;WANG Zhao;GAO Xueliang;JIA Peilei;ZHANG Nan;WANG Kai;CHENG Jianye(Department of Neurosurgery,Hebei Province Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院神经外科,石家庄050011

出　　处：《疑难病杂志》2018年第11期1280-1282,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察血管内介入栓塞治疗非Galen型脑动静脉瘘的效果。方法回顾分析2016年5月—2018年3月河北省中医院神经外科住院治疗的非Galen型脑动静脉瘘患者6例的血管内栓塞治疗临床资料。单瘘口5例,多瘘口1例;动脉入路4例,静脉入路1例,动脉联合静脉入路1例;分期栓塞1例,均采用弹簧圈结合Onyx胶栓塞,其中球囊辅助3例。结果 6例硬膜动静脉瘘患者均无出血、过度栓塞等并发症,无死亡病例,栓塞满意,术后随访6～18个月,并复查造影无复发,症状均能得到缓解。结论弹簧圈和/或球囊辅助Onyx胶栓塞治疗非Galen型脑动静脉瘘可行,效果良好;对于高流量动静脉瘘,应用球囊和/或弹簧圈可降低血流,结合Onyx胶栓塞瘘口安全可靠。Objective To investigate the therapeutic effects of endovascular interventional embolization on nongalenic cerebral arteriovenous fistula.Methods The clinical data of 6 patients with nongalenic cerebral arteriovenous fistula who underwent endovascular treatment from May 2016 to March 2018 were analyzed retrospectively.Among them,5 cases were single fistula,1 case was multiple fistulas.1 case received comprehensive staging embolization.All the cases were embolized by coil in combination with Onyx glue,3 cases with balloon-assisted,4 cases with trans-arterial approach,1 case with trans-venous approach,1 case with arterial combined venous approach.Results All the patients were embolized successfully and no related complications,such as bleeding,excessive embolization,death were observed.All the cases were followed up postoperatively ranged from 6 to 18 months,with alleviated symptoms and no recurrence confirmed by repeated angiography.Conclusion Coil and/or balloon-assisted Onyx glue embolization was feasible and effective for the treatment of nongalenic cerebral arteriovenous fistula;Using balloons and/or coils helps to reduce the velocity of blood flow,united with Onyx glue helps to embolize the fistulas in patients with high-flow arteriovenous fistula.

关 键 词：动静脉瘘 非Galen型 血管内栓塞治疗 弹簧圈 球囊 ONYX胶 

分 类 号：R743[医药卫生—神经病学与精神病学]