海绵窦区硬脑膜动静脉瘘的介入治疗分析  

Clinical efficacy of interventional treatment for patients with cavernous sinus dural arteriovenous fistulas:report of 21 cases

作　　者：于正涛[1] 蒋俊文 李由 李佳梦 陈焕雄[1] 夏鹰[1] YU Zheng-tao;JIANG Jun-wen;LI You;LI Jia-meng;CHEN Huan-xiong;XIA Ying(Department of Neurosurgery,Haikou Hospital,Xiangya Medical College,Central South University,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院神经外科医学部,海口570208

出　　处：《中国临床神经外科杂志》2023年第6期361-364,共4页Chinese Journal of Clinical Neurosurgery

基　　金：海南省脑血管病临床研究中心专项(LCYX202206);海南省卫生健康行业科研项目(20A200063)。

摘　　要：目的探讨海绵窦区硬脑膜动静脉瘘的介入治疗方法及其疗效。方法回顾性分析2013年1月至2023年1月介入治疗的21例海绵窦区硬膜动静脉瘘的临床资料。结果经股静脉-岩下窦途径16例,经颈外动脉入路4例,经动静脉联合入路1例;采用弹簧圈联合Onyx-18胶栓塞17例,单纯应用弹簧圈1例,单用Onyx-18胶3例;术后即刻造影显示瘘口完全闭塞18例,次全闭塞3例。术后随访3~12个月,临床治愈17例,好转4例。15例复查造影未见瘘口复发。结论根据海绵窦区硬脑膜动静瘘血管构筑特征,采用个体化的血管内治疗方案,可以获得满意的临床疗效。Objective To investigate the clinical efficacy of interventional treatment for patients with cavernous sinus dural arteriovenous fistulas(CS-DAVF).Methods The clinical data of 21 patients with CS-DAVF who received interventional treatment from January 2013 to January 2023 were retrospectively analyzed.Results Of 21 patients,16 patients(76%)were treated via femoral veininferior petrosal sinus approach,4 patients(19%)via external carotid artery approach and 1 patient(5%)via combined arteriovenous approach.Coils and Onyx-18 glue were used in 17 patients(81%),only Onyx-18 glue in 3 patients(14%),and only coils in 1 patient(5%).Immediate postoperative angiography showed complete occlusion of fistula in 18 patients and subtotal occlusion in 3.The followup(3~12 months)showed that 17 patients were cured and 4 were improved.The angiography of 15 patients during the follow-up showed no recurrence of fistulas.Conclusions Interventional treatment via individualized approaches according to the characteristics of CSDAVF angioarchitectures can obtain good clinical efficacy for patients with CS-DAVF.

关 键 词：海绵窦区硬脑膜动静脉瘘 血管内治疗 疗效 

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]