Apollo头端可解脱微导管结合液态栓塞剂治疗脑动静脉畸形  

Interventional embolotherapy of cerebral arteriovenous malformations with Apollo detachable microcatheter and liquid embolic agent

作　　者：那世杰[1] 刘涛[1] 凌海平 张玉华 鲁悦 宋永福 张庆荣 倪红斌[1] NA Shi-jie;LIU Tao;LING Hai-ping(Department of Neurosurgery,The Affiliated Drum Tower Hospital,School of Medicine,Nanjing University,Nanjing 210000,China)

机构地区：[1]南京大学医学院附属鼓楼医院神经外科,南京210000 [2]南京医科大学第四附属医院神经外科

出　　处：《临床神经外科杂志》2021年第4期361-365,370,共6页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金面上项目(81971127)。

摘　　要：目的探讨Apollo头端可解脱微导管栓塞治疗脑动静脉畸形的疗效、安全性和使用经验。方法回顾性分析22例脑动静脉畸形患者的临床资料。患者的脑动静脉畸形均单独使用Apollo头端可解脱微导管,或联合使用其他微导管进行栓塞治疗。结果本组患者中治愈性栓塞12例、显微外科术前辅助栓塞4例、靶向性栓塞动脉瘤并部分栓塞动静脉畸形2例及部分栓塞4例。共使用25根Apollo头端可解脱微导管,栓塞后均顺利从血管内拔除;有5根导管解脱点未分离,将导管完全拔出。患者术中均未出现Apollo导管相关并发症。术后半年,临床随访17例患者,格拉斯哥预后量表(GOS)评分4~5分,均预后良好;12例患者复查脑血管造影,治愈性栓塞和栓塞后切除病例均未见复发。结论Apollo头端可解脱微导管能解决因液态栓塞材料反流过多而导致拔管困难的问题,降低拔管风险,并明显缩短手术时间,提高脑动静脉畸形栓塞治疗的治愈率。Objective To explore the clinical effect and experience of the interventional embolotherapy of cerebral arteriovenous malformations with Apollo detachable tip microcatheter.Methods The clinical data of 22 patients with cerebral arteriovenous malformation diagnosed by DSA were analyzed retrospectively.All the patients were treated with Apollo detachable tip microcatheter alone or with other microcatheter.Results Among the 22 patients,12 were cured,4 were assisted embolization before microsurgery,2 were targeted embolization of accompanying aneurysm with partial arteriovenous malformation embolization,and 4 were partial embolization.A total of 25 Apollo detachable tip microcatheters were used and extubated successfully.Tip detachment occurred in 17 Apollo detachable tip microcatheters,and 5 catheters were completely pulled out.There were no complications related to Apollo catheter during the operation.17 cases were followed up clinically and all of them had favorable prognosis(GOS score 4-5),of which 12 cases were followed up by imaging(DSA),no recurrence was found in the cured or post-embolization resection cases.Conclusions Apollo detachable tip microcatheter can solve the problem of catheter retain caused by the excessive reverse flow of liquid embolization materials,and reduce the risk of extubation.Use of Apollo detachable tip microcatheter can significantly shorten the operation time,and improve the cure rate of cerebral arteriovenous malformation embolization.

关 键 词：脑动静脉畸形 介入栓塞 Apollo头端可解脱微导管 液态栓塞剂 

分 类 号：R651.1[医药卫生—外科学]