CAJ | 학술논문

目的探讨经动脉入路Onyx胶栓塞治疗颈外动脉分支为主要供血的海绵窦区硬脑膜动静脉瘘(CSDAVF)的可行性、并发症和疗效.方法回顾性分析2005年8月至2014年10月收治的15例(其中北京天坛医院神经介入科13例,榆林市第二医院神经外科2例)Onyx胶栓塞治疗颈外动脉分支为主要供血的CSDAVF的临床资料和随访结果.结果术后即刻造影提示12例完全栓塞,3例瘘口部分残留.术后眼部症状缓解14例,并发同侧面部麻木3例,面瘫1例,复视1例.随访3 ～ 24个月,造影结果提示13例完全治愈,1例造影提示复发行二次栓塞治疗,1例残留较前无变化.临床随访提示眼部症状均缓解,无出血,并发症状均缓解.结论经颈外动脉分支入路微导管可到达瘘口的CSDAVF,Onyx胶栓塞治疗CSDAVF是可行的,是经静脉入路不能到位或者治疗失败后的替选方案.
목적 탐토경동맥입로Onyx효전새치료경외동맥분지위주요공혈적해면두구경뇌막동정맥루(CSDAVF)적가행성、병발증화료효.방법 회고성분석2005년8월지2014년10월수치적15례(기중북경천단의원신경개입과13례,유림시제이의원신경외과2례)Onyx효전새치료경외동맥분지위주요공혈적CSDAVF적림상자료화수방결과.결과 술후즉각조영제시12례완전전새,3례루구부분잔류.술후안부증상완해14례,병발동측면부마목3례,면탄1례,복시1례.수방3 ～ 24개월,조영결과제시13례완전치유,1례조영제시복발행이차전새치료,1례잔류교전무변화.림상수방제시안부증상균완해,무출혈,병발증상균완해.결론 경경외동맥분지입로미도관가도체루구적CSDAVF,Onyx효전새치료CSDAVF시가행적,시경정맥입로불능도위혹자치료실패후적체선방안.
Objective To investigate the feasibility,complications and efficacy of main blood-supply cavernous sinus dural arteriovenous fistulas (CSDAVFs) for the embolization treatment of the branches of external carotid artery with Onyx via artery approach.Methods The clinical data and follow-up results of 15 patients (13 patients from the Neurointerventional Department of Beijing Tiantan Hospital and 2 patients from the Department of Neurosurgery,the Second Hospital of Yulin) treated with the main blood-supply CSDAVFs for the embolization treatment of the branches of external carotid artery with Onyx from August 2005 to October 2014 were analyzed retrospectively.Results Immediately after procedure,angiography revealed that 12 patients were embolized completely,3 had partially residual fistula.The postoperative ocular symptoms of 14 patients were relieved,3 complicated with ipsilateral facial numbness,one had facial paralysis,and one had diplopia.They were followed up for 3 to 24 months,angiographic findings revealed that 13 patients were cured completely,one had recurrence and received the second embolization,and the residue did not have any change in one case.The clinical follow-up showed that their ocular symptoms were all relieved,no hemorrhage was observed,and all the complications were relieved.Conclusions Microcatheter can reach CSDAVFs of fistula via the branches of external carotid artery approach.Onyx embolization of CSDAVFs is feasible.It is an alternative scheme which the microcatheter can not be in place via venous approach or after treatment failure.