[1]张力,王汉东,潘云曦,等.海绵窦区硬脑膜动静脉瘘的临床特点和介入栓塞治疗[J].临床神经外科杂志,2018,15(06):406-414.[doi:10.3969/j.issn.1672-7770.2018.06.002]
 ZHANG Li,WANG Han-dong,PAN Yun-xi,et al.Clinical characteristics and interventional embolization therapy for cavernous sinus dural arteriovenous fistula[J].Journal of Clinical Neurosurgery,2018,15(06):406-414.[doi:10.3969/j.issn.1672-7770.2018.06.002]
点击复制

海绵窦区硬脑膜动静脉瘘的临床特点和介入栓塞治疗()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
15
期数:
2018年06期
页码:
406-414
栏目:
动静脉畸形专题
出版日期:
2018-12-15

文章信息/Info

Title:
Clinical characteristics and interventional embolization therapy for cavernous sinus dural arteriovenous fistula
作者:
张力王汉东潘云曦丁可祝剑虹茅磊
210002 南京,东部战区总医院神经外科
Author(s):
ZHANG LiWANG Han-dongPAN Yun-xiet al.
Department of Neurosurgery,Jinling Hospital,School of Medicine,Nanjing University,Nanjing 210002,China
关键词:
海绵窦区硬脑膜动静脉瘘临床特点介入栓塞治疗
Keywords:
cavernous sinus dural arteriovenous fistulaclinical characteristicsinterventional embolization therapy
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2018.06.002
文献标志码:
A
摘要:
【摘要】目的探讨海绵窦区硬脑膜动静脉瘘(cavernous sinus dural arteriovenous fistula,CSDAVF)的临床特点及介入栓塞治疗。方法回顾性分析东部战区总医院神经外科2008年5月至2018年5月收治的23例行介入栓塞治疗的CSDAVF患者的临床资料。所有患者术前均行DSA检查明确诊断并了解瘘口的部位、大小、供血动脉和引流静脉。23例患者中5例经动脉入路栓塞治疗,主要针对Barrow分型C型的患者;19例经静脉入路栓塞治疗,针对Barrow分型B型、C型或D型的患者。结果5例经动脉入路栓塞治疗的患者中3例使用Onxy胶栓塞,其中1例治愈,瘘口完全消失,2例好转,瘘口部分残留,因部分供血动脉纤细扭曲,栓塞风险高,遂未完全栓塞;另外2例使用Onxy胶联合弹簧圈栓塞,均治愈,瘘口完全消失。5例经动脉入路栓塞治疗的患者术后均无明显并发症,症状较术前有不同程度的好转。5例患者中2例术后长期随访,3个月~3年,定期复查DSA。其中1例完全栓塞的患者无复发,1例部分栓塞的患者瘘口仍有残留,较出院时无明显变化。18例经静脉入路栓塞治疗的患者中9例使用Onxy胶栓塞,9例使用Onxy胶联合弹簧圈栓塞,均治愈,瘘口完全消失,术后均无明显并发症,症状较术前有不同程度的好转。其中12例术后长期随访,3个月~3年,定期复查DSA无复发。结论介入栓塞是治疗 CSDAVF的首选方法,静脉入路使用Onxy胶联合弹簧圈栓塞具有适应证广、栓塞完全的特点,是治疗CSDAVF的有效方法。
Abstract:
Abstract:ObjectiveTo analyze the clinical characteristics and interventional embolization therapy for cavernous sinus dural arteriovenous fistula (CSDAVF).MethodsThe clinical data of 23 patients with CSDAVF underwent interventional embolization therapy from May 2008 to May 2018 in the neurosurgical department of Jinling Hospital were analyzed retrospectively .All patients received preoperative DSA to identify the location,size,feeding arteries and draining veins of the fistulas.Of 23 patients,5 of mainly Barrow C type were treated by transarterial embolization and 18 of Barrow B,C or D type were treated by transvenous embolization.ResultsOf 5 patients treated by transarterial embolization,3 were embolized with Onxy glue,of which 1 was cured and the fistula completely disappeared while 2 were improved and the fistulas were residual.Part of the feeding arteries were thin and distorted and the embolism risk was very high so the fistulas were not completely embolized.The other 2 patients embolized with Onxy glue and coils were cured and the fistulas completely disappeared.5 patients treated by transarterial embolization had no complications after operation,the clinical symptoms were improved in different degrees.Of these 5 patients,2 were followed up for a long time 3 months~3 years,periodically review DSA.1 patient completely embolized had no recurrence and 1 patient partially embolized remained unchanged.Of the 18 patients treated by transvenous embolization,9 patients were embolized with Onxy glue and 9 patients were embolized with Onxy glue and coils.All the patients were cured and the fistulas completely disappeared.There were no obvious complications after operation and the clinical symptoms were improved in different degrees.Of these 18 patients,12 patients were followed up for a long time 3 months3 years,periodically review DSA without recurrence.ConclusionsInterventional embolization is the first choice for the treatment of CSDAVF.Transvenous embolization with Onxy glue and coils has the characteristics of wide adaptation and complete embolism,which is an effective method for the treatment of CSDAVF.

相似文献/References:

[1]马文超,唐晓平,罗波.肝细胞癌脑转移1例报告并文献复习[J].临床神经外科杂志,2015,(05):385.
[2]宋坤,王娟,柴学,等.室管膜下瘤9例临床分析[J].临床神经外科杂志,2016,(02):131.
 SONG Kun,WANG Juan,CHAI Xue,et al.Clinical analysis of 9 paitients with subependymoma[J].Journal of Clinical Neurosurgery,2016,(06):131.
[3]闵杰,吴明灿,姚远,等.《多囊肾合并颅内动脉瘤性蛛网膜下腔出血2例临床分析并文献复习》[J].临床神经外科杂志,2017,14(02):142.
 MIN Jie,WU Ming-can,YAO Yuan,et al.Analysis of treatment and review of literature in two patients with autosomal-dominant polycystic kidney disease aneurysmal subarachnoid hemorrhage[J].Journal of Clinical Neurosurgery,2017,14(06):142.
[4]张永芹,孙秀锦,左云,等.肺癌脑转移患者中不同EGFR突变状态下的临床及影像学特点[J].临床神经外科杂志,2018,15(03):179.
 ZHANG Yong-qin,SUN Xiu-jin,ZUO Yun,et al.Clinical and imaging features between different EGFR mutation patients with brain metastasis from lung[J].Journal of Clinical Neurosurgery,2018,15(06):179.
[5]李锐,张茂柏,李志兵,等.胶质肉瘤的临床及MRI特点分析[J].临床神经外科杂志,2018,15(05):358.[doi:10.3969/j.issn.1672-7770.2018.05.010]
 LI Rui,ZHANG Mao-bai,LI Zhi-bing,et al.Analysis of MRI and clinical characteristics of gliosarcoma[J].Journal of Clinical Neurosurgery,2018,15(06):358.[doi:10.3969/j.issn.1672-7770.2018.05.010]
[6]张伟,郭强,陈俊喜,等.多形性黄色星形细胞瘤的临床及影像学特征分析[J].临床神经外科杂志,2018,15(06):457.[doi:10.3969/j.issn.1672-7770.2018.06.014]
 ZHANG Wei,GUO Qiang,CHEN Jun-xi,et al.Clinical and neuroimaging features of pleomorphic xanthoastrocytoma[J].Journal of Clinical Neurosurgery,2018,15(06):457.[doi:10.3969/j.issn.1672-7770.2018.06.014]

更新日期/Last Update: 1900-01-01