大脑大静脉区硬脑膜动静脉瘘血管内栓塞治疗效果分析  

Effect analysis of endovascular embolization of dural arteriovenous fistula in large cerebral vein area

作　　者：刘鹏[1] 桂思铭 蒋佳 李佑祥[1,2] Liu Peng;Gui Siming;Jiang Jia;Li Youxiang(Beijing Neurosurgical Institute,Capital Medical University,Beijing 100070,China;Neurosurgery Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学,北京市神经外科研究所,北京100070 [2]首都医科大学附属北京天坛医院神经外科学中心,北京100070

出　　处：《中华神经外科杂志》2025年第2期115-120,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(82171289)。

摘　　要：目的探讨大脑大静脉区硬脑膜动静脉瘘(DAVF)血管内栓塞治疗的效果。方法回顾性分析2016年10月至2021年10月于首都医科大学附属北京天坛医院神经外科学中心接受血管内栓塞治疗的6例大脑大静脉区DAVF患者的临床资料。根据患者全脑数字减影血管造影(DSA)情况采用单纯经动脉入路或动脉联合静脉入路进行动静脉瘘栓塞术。术后即刻及12个月左右复查DSA评估DAVF的栓塞程度,并根据术后随访资料评估临床预后情况。结果6例患者中,3例经动脉入路,3例经动脉联合静脉入路进行栓塞治疗,手术均成功。术后即刻DSA显示,5例完全栓塞,1例近全栓塞。术后6例患者均达到临床治愈,且术后均未出现严重神经系统并发症。术后中位随访时间为11.5个月(8~15个月),DSA随访结果显示,6例患者DAVF均为完全栓塞。结论对于大脑大静脉区DAVF患者,采用单纯经动脉入路或经动脉联合静脉入路行血管内栓塞治疗,术后即刻和12个月左右的栓塞率高,疗效好。ObjectiveTo investigate the effect of endovascular embolization of dural arteriovenous fistula(DAVF).MethodsThe clinical data of 6 patients with DAVF who underwent intravascular embolization at the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from October 2016 to October 2021 were retrospectively analyzed.According to the whole-brain digital substraction angiography(DSA),venous fistula embolization was performed via simple transarterial approach or combined arterial and venous approach.The embolization degree of DAVF was evaluated by DSA immediately after surgery and about 12 mouths later,and the clinical outcome was evaluated according to the postoperative follow-up data.ResultsAmong the 6 patients,3 cases were embolized by arterial approach and 3 cases by arterial combined with venous approach,the operations were all successful.Immediate postoperative DSA showed that 5 cases were completely embolized and 1 case was nearly completely embolized.All the 6 patients achieved clinical cure after surgery,and no serious neurological complications occurred after surgery.The median follow-up was 11.5 months(8-15 months).Postoperative DSA follow-up showed that DAVF was completely embolized in all 6 patients.ConclusionFor the patients with DAVF in the large cerebral vein area,the embolization rates immediately and about 12 mouths after endovascular treatment with simple transarterial access and transarterial combined transvenous access are high and the the efficacy is good.

关 键 词：动静脉瘘 栓塞 治疗性 血管内操作 治疗结果 预后 

分 类 号：R74[医药卫生—神经病学与精神病学]