Combined Endovascular and Surgical Treatment for Brain Arteriovenous Malformations in Biplanar Hybrid Operating Room  

作　　者：Can XIN Wen-ting LUO Wen-yuan ZHAO Li-xin DONG Zhong-wei XIONG Zheng-wei LI Jian-jian ZHANG Jin-cao CHEN 

机构地区：[1]Department of Neurosurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China [2]Department of Ultrasound,Zhongnan Hospital of Wuhan University,Wuhan 430071,China

出　　处：《Current Medical Science》2021年第4期782-787,共6页当代医学科学（英文）

基　　金：supported by grants from the National Natural Science Foundation of China(No.81771280);the Technological Innovation Foundation of Hubei Province(No.2018ACA139).

摘　　要：Objective Combined surgical and endovascular treatment for vascular disorders has become prevalent in recent years.However,reports on one-session hybrid surgery for arteriovenous malformations(AVMs)are relatively rare.The safety and efficiency of combined treatment for brain AVMs were analyzed in biplanar hybrid operating room(OR)at one stage.Methods We retrospectively analyzed 20 patients with AVMs undergoing combined surgical and endovascular treatment from October 2015 to June 2018.The data for resection rate,microcatheter adhesion,surgical position and postoperative outcomes were analyzed.Total resection or near-total resection was achieved in all cases.Results A total of 13 patients were under combined endovascular and surgical procedures,and 7 experienced surgery with intraoperative digital subtraction angiography.Sitting position was applied in 3 of them;2 niduses in cerebellum,and 1 in parietal lobe.Compared with admission modified Rankin Scale(mRS)in all patients,postoperative 12-month mRS showed a significant decline.Besides,3 patients experienced microcatheter adhesion after endovascular embolization,thereafter underwent surgical adhesion removal while nidus resection was done.Conclusion Combined endovascular and surgical modality in a hybrid OR at one stage provides a safe strategy for the treatment of AVMs.The biplanar hybrid neurointerventional suite is endowed with unconstrained operating angle which enables combined endovascular and surgical treatment in sitting position.It also reduces the risk of microcatheter adhesion,which enables interventional radiologists to perform aggressively.

关 键 词：arteriovenous malformation MICROSURGERY endovascular treatment hybrid operating room sitting position microcatheter adhesion 

分 类 号：R73[医药卫生—肿瘤]