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目的 ;评价NBCA栓塞治疗脑AVMs的临床效果。材料和方法 :36例脑AVMs患者(临床表现为脑出血14例 ,癫16例 ,其他6例) ,均经完整的血管造影检查、畸形血管的血管构筑学研究和Spetzler分级 ,在供血动脉选择性血管造影后注入NBCA ,术后即刻行血管造影 ,半年后行MRI检查 ,以评估栓塞的近、远期效果。结果 :术后即刻血管造影显示闭塞范围大于90 %为11例(30.5 %) ,70 %～90 %为8例(22.2 %) ,50 %～69 %为10例(27.8 %) ,小于50 %为7例(19.4 %)。在9例患者 ,术后6个月随访MRI检查显示栓塞区无再通。36例中 ,术后有较严重并发症3例 ,1例为脑干旁AVM ,术后存在永久性轻度共济失调 ;1例为颞巨大AVM ,术中并发蛛网膜下腔出血 ,保守治疗2星期后康复 ;另1例为颞深AVM ,栓塞后出现短暂的神经功能缺失。结论 :脑AVMs血管构筑学研究在NBCA栓塞术中是必需的 ,在单支终末供养动脉的脑AVMs ,NBCA栓塞可获完全治愈。
Objective To evaluate the clinical efficacy of NBCA embolization in the treatment of brain AVMs. MATERIALS AND METHODS: Thirty-six patients with brain AVMs (14 with intracerebral hemorrhage, 16 with epilepsy and 6 with other clinical manifestations) were examined by complete angiography, vascular architecture and malformation of Spearsler grading, Selective angiography after injection of NBCA, angiography immediately after surgery, six months after the line MRI examination to assess the proximal and distal embolization effect. Results: Immediate angiography showed that the occlusion range was more than 90% in 11 cases (30.5%), 70% ~ 90% in 8 cases (22.2%), 50% ~ 69% 7 cases (19.4%). In 9 patients, 6 months after the follow-up MRI showed no re-embolization area. Among the 36 cases, there were 3 cases of more severe complications after operation, 1 case of AVM beside the brain stem, permanent mild ataxia after operation, 1 case of giant temporal AVM with subarachnoid hemorrhage and conservative After 2 weeks of treatment, rehabilitation was performed. In the other case, deep temporal AVM was performed. Short-term neurological deficits occurred after embolization. CONCLUSIONS: Brain AVMs vascular architecture studies are necessary for NBCA embolization and are completely curable with AVMs and NBCA embolization in single-feeder-fed arteries.