血管内栓塞治疗硬脑膜动静脉瘘的疗效分析  

Clinical efficacy of endovascular embolization for patients with dural arteriovenous fistula

作　　者：高亚强 汪雷[1] 马金阳[1] 符常涛 胡火军[1] GAO Ya-qiang;WANG Lei;MA Jin-yang;FU Chang-tao;HU Huo-jun(The First College of Clinical Medical Science,China Three Gorges University Yichang 443003,China;Department of Neurosurgery,Yichang Central People's Hospital,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院/宜昌市中心人民医院神经外科,湖北宜昌443003

出　　处：《中国临床神经外科杂志》2024年第3期135-138,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨硬脑膜动静脉瘘的血管内栓塞治疗方法及其疗效。方法回顾性分析2017年1月至2023年1月收治的47例硬脑膜动静脉瘘的临床资料。结果经动脉入路栓塞(TAE)治疗42例,其中40例术后即刻完全栓塞,1例次全栓塞,1例部分栓塞;经静脉入路栓塞(TVE)治疗5例术后即刻均完全栓塞。出院时改良Ranking量表(mRS)评分0~1分46例,5分1例。术后6个月随访,1例死亡,其余46例复查DSA显示完全栓塞42例(91.3%),次全栓塞4例(8.7%),其中TAE组复发2例(4.9%),TVE组复发2例(40.0%);mRS评分0分39例,1分7例。结论血管内栓塞是治疗DAVF的有效方法,手术方式需根据病人具体情况进行选择,如供血动脉数目及走行,不同病变位置以及引流静脉的血管情况等。Objective To explore the endovascular embolization approaches for dural arteriovenous fistulas(DAVF)and their therapeutic efficacies.Methods The clinical data of 47 patients with DAVF admitted to our hospital from January 2017 to January 2023 were retrospectively analyzed.Results Forty-two patients were treated via transarterial embolization(TAE),among which 40 patients achieved complete embolization immediately after the operation,1 had subtotal embolization,and 1 had partial embolization.Five patients were treated via transvenous embolization(TVE),and all achieved complete embolization immediately after the operation.At discharge,46 patients had a modified Ranking scale(mRS)score of 0~1,and 1 had a mRS score of 5.During the 6-month follow-up,1 patient died.The reexamination of DSA of the survival 46 patients revealed that 42 patients(91.3%)had complete embolization and 4(8.7%)had subtotal embolization[2 patients(4.9%)treated via the TAE recurred and 2(40.0%)via TVE recurred].A mRS score of 0 was achieved in 39 patients and a mRS score of 1 in 7.Conclusions Endovascular embolization is an effective method for tratment of patients with DAVF.The surgical approach should be selected based on the specific conditions of patients,such as the number and running course of the feeding arteries,lesion locations,and the vascular conditions of the draining veins.

关 键 词：硬脑膜动静脉瘘 血管内栓塞治疗 经动脉入路栓塞 经静脉入路栓塞 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]