海绵窦区硬脑膜动静脉瘘介入治疗的疗效分析  

Clinical efficacy of interventional treatment for patients with cavernous sinus dural arteriovenous fistula

作　　者：杨振兴[1] 孙阳阳 冯进[1] 万定[1] 黄德俊[1] 李宗正[1] YANG Zhen-xing;SUN Yang-yang;FENG jin;WAN Ding;HUANG De-jun;LI Zong-zheng(Department of Neurosurgery,General Hospital of Ningxia Medical University,Yinchuang,750004,China)

机构地区：[1]宁夏医科大学总院神经外科,银川750004

出　　处：《中国临床神经外科杂志》2021年第10期769-771,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨弹簧圈+Onyx-18胶栓塞治疗海绵窦区硬脑膜动静脉瘘(CS-DAVF)的疗效。方法回顾性分析2012年1月至2020年1月介入治疗的42例CS-DAVF的临床资料。先采用弹簧圈栓塞以降低血流速度,再用Onyx-18胶栓塞;经静脉入路32例,经动脉入路5例,动静脉联合入路5例。结果术后即刻DSA显示瘘口均消失,完全栓塞31例(73.8%),次全栓塞11例(26.2%)。无手术死亡病例。术后6~12个月,42例DSA随访,1例复发;临床症状消失34例(81.0%),3例视力无明显改善,5例术后伴有外展神经麻痹。结论采用弹簧圈联合Onyx-18胶介入栓塞治疗CS-DAVF的效果良好。可根据病人的具体情况选择静脉途经、动脉途径或动静脉联合途径。Objective To investigate the clinical efficacy of endovascular embolization using coil combined with Onyx-18 glue for the patients with cavernous sinus dural arteriovenous fistula(CS-DAVF).Methods The clinical data of 42 patients with CS-DAVF who received endovascular embolization from January 2012 to January 2020 were analyzed retrospectively.First,the coils was used to reduce the blood flow velocity,and then the Onyx-18 glue was used to embolize the fistulas.Of 42 patients,32 patients were embolized via venous approach,5 via arterial approach,and 5 via arteriovenous approach.Results Immediately after the operation,DSA showed that 31 patients(73.8%)were completely embolized,and 11(26.2%)subtotally.There were no surgical death.The follow-up(6~12 months)results showed that the fistula reccurred in 1 patient;clinical symptoms were disappeared in 34 patients,no obvious improvement in visual acuity occurred in 3,and abductor nerve palsy in 5.Conclusions Endovascular embolization using coil combined with Onyx-18 glue is an effective treatment for the patients with CS-DAVF.The venous approach,arterial approach or arteriovenous approach can be selected according to the patients'specific conditions.

关 键 词：海绵窦区硬脑膜动静脉瘘 介入治疗 动脉途径 静脉途径 动静脉联合途径 疗效 

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