岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧海绵窦区硬脑膜动静脉瘘  

Transvenous embolization of bilateral cavernous sinus dural arteriovenous fistulas with Onyx and coils via inferior petrosal sinus approach

作　　者：刘建武 罗海涛 陈志华[1] 赖贤良[1] 宋书欣[1] 毛国华[1] 朱健明[1] LIU Jian-wu;LUO Hai-tao;CHEN Zhi-hua;LAI Xain-liang;SONG Shu-xin;MAO Guo-hua;ZHU Jain-ming(Department of Neurosurgery,Second Affiliated Hospital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院神经外科

出　　处：《中国临床神经外科杂志》2019年第9期519-521,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧海绵窦区硬脑膜动静脉瘘(CSDAVF)的安全性和有效性。方法回顾性分析2013年9月至2018年9月经岩下窦入路Onyx胶联合弹簧圈栓塞治疗的7例双侧CSDAVF的临床资料。结果7例14侧CSDAVF中,完全栓塞13侧,次全栓塞1侧。术后动眼神经麻痹加重1例,外展神经麻痹加重1例。术后随访6个月,14侧瘘口均未显影,1例动眼神经麻痹基本恢复,1例外展神经麻痹部分恢复。结论经岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧CSDAVF疗效确切,并发症较单侧更常见;有效使用弹簧圈及Onyx胶对手术成功及减少并发症至关重要。Objective To investigate the safety and outcomes of transvenous embolization of bilateral cavernous sinus dural arteriovenous fistulas (CSDAVF) with Onyx and coils.Method The clinical and follow-up data of 7 patients with bilateral CSDAVF who accepted transvenous embolization with onyx and coils via inferior petrosal sinus approach from September,2013 to September,2018 were analyzed retrospectively.Results Of 14 CSDAVF in 7 patients with bilateral CSDAVF,13 were totally embolized and 1 subtotally. One patient had aggravation of oculomotor paralysis and 1 patient had aggravation of abducent paralysis after the embolization.The following-up 6 months after the embolization showed that CSDAVF did not recurred in all the patients.The patient was basically recovered from oculomotor paralysis,and the another patient was slightly recovered from abducent paralysis.Conclusions The clinical effect of transvenous embolization of CSDAVF with Onyx and coils via inferior petrosal sinus approach is good,but the complications are more common after the embolization in the patients with bilateral CSDAVF than those in the patients with unilateral CSDAVF.The practised skill of endovascular emboliation is very important to successful treatment of CSDAVF and reducing complications.

关 键 词：海绵窦区硬脑膜动静脉瘘 血管内栓塞 岩下窦入路 ONYX胶 弹簧圈 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]