CAJ | 학술논문

目的评价分次栓塞治疗大型颅内动静脉畸形(AVM)的疗效.方法 23例大型(直径≥6 cm)颅内AVM患者,分次行AVM栓塞术,8例栓塞后行γ-刀治疗,术后随访1-2年,评估治疗效果.结果 14例达到完全栓塞,治疗过程中再次出血3例,脑梗死4例.影像学治愈19例；20例GOS评分较术前无下降,2例GOS评分较术前下降,1例死亡.结论分次栓塞治疗大型颅内AVM可取得良好的影像学和临床疗效.立体定向放射治疗是较好的辅助治疗手段.
목적 평개분차전새치료대형로내동정맥기형(AVM)적료효.방법 23례대형(직경≥6 cm)로내AVM환자,분차행AVM전새술,8례전새후행γ-도치료,술후수방1-2년,평고치료효과.결과 14례체도완전전새,치료과정중재차출혈3례,뇌경사4례.영상학치유19례；20례GOS평분교술전무하강,2례GOS평분교술전하강,1례사망.결론 분차전새치료대형로내AVM가취득량호적영상학화림상료효.입체정향방사치료시교호적보조치료수단.
Objective To investigate the complications and follow - up results of staged embolization therapy on patients with large brain arteriovenous malformations ( AVM ) and to evaluate the efficacy of this technique.Methods Twenty -three patients with large AVMs (diameter≥6 cm) were embolized individually for several sessions,with more than one month intervals between embolization stages.Eight patients were treated by γ-knife after the embolization.Twenty - two of them experienced clinical and angiographic follow - up.Results Complete nidus obliteration was found in 14 patients after embolization.Three patients suffered from cerebral hemorrhage in the whole embolization therapy sequence,and 4 from cerebral infarction.At follow- up after the whole treatment sequence,19 cases were completely obliterated,20 had better clinical results,2 had worse results and 1 patient died.Conclusions The patient with large brain AVM could be cured by staged embolization.Stereotactic radiosurgery is an effective assistant therapy for large AVMs.