血管内介入栓塞治疗脑动静脉畸形的疗效与影响因素  

Efficacy and influencing factors of endovascular embolization in the treatment of cerebral arteriovenous malformations

作　　者：於新军 肖胜辉 李百升 邹长林 陈健球 Yu Xinjun;Xiao Shenghui;Li Baisheng;Zou Changlin;Chen Jianqiu(Department of Neurosurgery,The Sixth Affiliated Hospital of South China University of Technology,Foshan,Guangdong 528200,China;Department of Cerebrovascular Intervention,The Sixth Affiliated Hospital of South China University of Technology,Foshan,Guangdong 528200,China)

机构地区：[1]华南理工大学附属第六医院神经外科,广东佛山528200 [2]华南理工大学附属第六医院脑血管介入科,广东佛山528200

出　　处：《中国微侵袭神经外科杂志》2024年第9期522-525,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：佛山市科技局课题(编号:2220001004471)。

摘　　要：目的 探讨血管内介入栓塞治疗脑动静脉畸形(arteriovenous malformation,AVM)的疗效及影响因素。方法 回顾性分析41例接受血管内介入栓塞治疗的AVM病例资料,其中前循环供血26例,后循环供血6例,前后循环供血9例,单支供血动脉2例,合并动脉瘤18例,合并静脉球1例。结果 AVM即刻闭塞率为68.29%(28例),经分次栓塞后总的闭塞率为85.36%(35例),其中Spetzler-Martin分级Ⅰ~Ⅱ级患者完全闭塞23例、Ⅲ级4例、Ⅳ~Ⅴ级1例。治疗过程中出现出血并死亡1例,局部脑缺血1例。随访预后良好,即改良Rankin量表(modified Rankin scale,mRS)评分≤2分者39例(95.12%)。经卡方检验发现血管内介入栓塞治疗后的脑AVM闭塞情况与病灶直径有关(P=0.042)。结论 介入栓塞是脑AVM一种安全有效的治疗方法,病灶直径越小,完全闭塞率越高,效果越好。Objective To investigate the efficacy and influencing factors of endovascular embolization in the treatment of cerebral arteriovenous malformations(AVM).Methods The clinical data of 41 patients with AVM who underwent endovascular embolization were analyzed retrospectively,including 26 cases of anterior circulation,6 cases of posterior circulation,9 cases of anterior and posterior circulation,2 cases of single artery,18 cases of combined aneurysm,and 1 case of combined venous balloon.Results The immediate occlusion rate of AVM was 68.29%(28 cases),and the total occlusion rate after staged embolization was 85.36%(35 cases),of which the complete embolization was 23 cases in Spetzler-Martin gradeⅠ-Ⅱ,4 in gradeⅢand 1 in gradeⅣ-Ⅴ.There was one case of hemorrhage and death during treatment and 1 case of localized cerebral ischemia.There were 39 cases(95.12%)with discharge mRS score≤2.The chi-square test revealed that the occlusion status of cerebral AVM after endovascular embolization was related to the lesion diameter(P=0.042).Conclusions Endovascular embolization is a safe and effective treatment for cerebral AVM.Smaller lesion diameters are associated with higher complete occlusion rates and better outcomes.

关 键 词：颅内动静脉畸形 介入栓塞 闭塞率 并发症 

分 类 号：R651.12[医药卫生—外科学]