海绵窦区硬脑膜动静脉瘘经静脉血管内治疗临床分析
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摘要
目的探讨海绵窦区硬脑膜动静脉瘘(CS-DAVF)患者经静脉入路行血管内栓塞治疗的安全性及有效性。方法回顾性分析2014-01—2017-10新疆医科大学第一附属医院神经外科经静脉入路使用onxy胶联合弹簧圈栓塞治疗的18例CSDAVF患者的临床及影像学资料。结果栓塞后即刻血管造影显示完全栓塞者15例(83.3%),次全栓塞者3例。1例患者术中出现暂时性心动过缓,术中给予对症治疗。出现同侧外展神经麻痹2例,一过性同侧视力减退1例。结论经随访,经静脉入路使用Onxy胶联合弹簧圈行血管内栓塞治疗CS-DAVF的方法安全、疗效确定。
Objective To investigate the safety and effectiveness of intravascular embolization in patients with cavernous sinus dural arteriovenous fistula(CS-DAVF)via venous approach.Methods A retrospective analysis from January 2014 to October2017,the clinical and imaging data of 18 CS-DAVF patients treated with onxy glue and coil embolization were analyzed in Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University.Results The immediate angiography after embolization showed that 15 cases(83.3%)were completely embolized and 3 cases were subtotal embolism.In 1 case,the problem of temporary bradycardia occurred during the operation,and symptomatic treatment was given during the operation.2 cases had ipsilateral abduction nerve palsy,and 1 case had an abnormal ipsilateral visual acuity.Conclusion After follow-up,the method of intravascular embolization of CS-DAVF with onxy glue combined with coils for the treatment of CS-DAVF is safe and effective.
Objective To investigate the safety and effectiveness of intravascular embolization in patients with cavernous sinus dural arteriovenous fistula(CS-DAVF)via venous approach.Methods A retrospective analysis from January 2014 to October2017,the clinical and imaging data of 18 CS-DAVF patients treated with onxy glue and coil embolization were analyzed in Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University.Results The immediate angiography after embolization showed that 15 cases(83.3%)were completely embolized and 3 cases were subtotal embolism.In 1 case,the problem of temporary bradycardia occurred during the operation,and symptomatic treatment was given during the operation.2 cases had ipsilateral abduction nerve palsy,and 1 case had an abnormal ipsilateral visual acuity.Conclusion After follow-up,the method of intravascular embolization of CS-DAVF with onxy glue combined with coils for the treatment of CS-DAVF is safe and effective.
引文
[1]胡骁.海绵窦区硬脑膜动静脉瘘血管内治疗的疗效评价[D].第四军医大学,2015.
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[11]陈圣攀,叶明,张鹏,等.经未显影岩下窦入路Onyx-18联合弹簧圈栓塞治疗海绵窦区硬脑膜动静脉瘘[J].中华神经外科疾病研究杂志,2016,15(2):117-120.
[12]YAKO R,MASUO O,KUBO K,et al.A case of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage[J].J Neurosurg,2016,124(3):726.
[13]郑琳,赵航,李实.经岩下窦栓塞治疗双侧海绵窦区硬脑膜动静脉瘘14例临床观察[J].中国初级卫生保健,2015,29(12):122-123.
[14]文军.海绵窦区硬脑膜动静脉瘘血管内介入治疗的临床研究[D].南方医科大学,2015.
[15]SASAMORI T,HIDA K,YANO S,et al.Long-term outco-mes after surgical and endovascular treatment of spinal dural arteriovenous fistulae[J].Eur Spine J,2016,25(3):748-754.
[16]HOLEKAMP T F,MOLLMAN M E,MURPHY R K,et al.Dural arteriovenous fistula-induced thalamic dementia:report of 4cases[J].J Neurosurg,2016,124(6):1 752.
[17]张艳杰,石见,杜敢琴.典型颅内静脉窦血栓形成合并硬脑膜动静脉瘘1例[J].河南科技大学学报(医学版)医学版,2017,35(1):60-62.
[18]李桂林,马永杰,任健,等.近端血流阻断增压技术栓塞岩尖部硬脑膜动静脉瘘[J].中国脑血管病杂志,2016,13(7):365-368.
[19]宋操,金恒伟,刘佳,等.经同侧岩下窦栓塞双侧海绵窦区硬脑膜动静脉瘘一例报道[J].中华神经创伤外科电子杂志,2017,(5):309-311.
[20]文军,段传志,黄理金,等.应用Onyx联合弹簧圈栓塞海绵窦治疗海绵窦区硬脑膜动静脉瘘的经验探讨[J].中华神经医学杂志,2015,14(5):501-505.
[21]李嘉楠,李强,冯明陶,等.静脉窦内球囊保护下Onyx栓塞侧窦区硬脑膜动静脉瘘的随访分析[J].中国脑血管病杂志,2017,14(3):149-154.
[2]张小伟,贺翔渝,刘兴媛,等.表现为蛛网膜下腔出血的海绵窦区硬脑膜动静脉瘘1例[J].中国介入影像与治疗学,2017,14(11):712-712.
[3]方兵,钱聪,许璟,等.经股静脉-颞浅静脉-眼上静脉栓塞海绵窦区硬脑膜动静脉瘘一例[J].中华神经外科杂志,2017,33(7):745-746.
[4]沈飞飞,陈柯言,燕兰云,等.海绵窦区硬脑膜动静脉瘘二例并文献复习[J].江苏医药,2016,42(19):2 143-2 145.
[5]李健,金科,惠卫宁.双侧海绵窦区硬脑膜动静脉瘘眼部表现一例[J].中华眼视光学与视觉科学杂志,2015,17(7):433-434.
[6]刘晓明,叶静,兰云.颅内硬脑膜动静脉瘘的病变部位与MRI的诊断价值分析[J].实用临床医药杂志,2017,21(7):12-15.
[7]LIN Y H,LI N H H,LIU H M,et al.Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula:a meta-analysis with indirect comparison[J].Neuroradiology,2016,58(8):1-11.
[8]王涛,李文纲,李士其,等.Onyx-18和(或)弹簧圈栓塞治疗海绵窦区硬脑膜动静脉瘘(附17例报道)[J].中国临床神经科学,2016,24(3):332-335.
[9]NGERAGEZA J G,HORIUCHI T,MURATA T,et al.Iatrogenic dural arteriovenousfistula after radical neck dissection for metastatic malignant disease:A case report[J].Head Neck,2016,38(4):E87-E90.
[10]LUO C B,CHANG F C,TENG M M,et al.Aggressive cavernous sinus dural arteriovenous fistula:Angioarchitecture analysis and embolization by various approaches[J].J Chin Med Assoc,2016,79(3):152-158.
[11]陈圣攀,叶明,张鹏,等.经未显影岩下窦入路Onyx-18联合弹簧圈栓塞治疗海绵窦区硬脑膜动静脉瘘[J].中华神经外科疾病研究杂志,2016,15(2):117-120.
[12]YAKO R,MASUO O,KUBO K,et al.A case of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage[J].J Neurosurg,2016,124(3):726.
[13]郑琳,赵航,李实.经岩下窦栓塞治疗双侧海绵窦区硬脑膜动静脉瘘14例临床观察[J].中国初级卫生保健,2015,29(12):122-123.
[14]文军.海绵窦区硬脑膜动静脉瘘血管内介入治疗的临床研究[D].南方医科大学,2015.
[15]SASAMORI T,HIDA K,YANO S,et al.Long-term outco-mes after surgical and endovascular treatment of spinal dural arteriovenous fistulae[J].Eur Spine J,2016,25(3):748-754.
[16]HOLEKAMP T F,MOLLMAN M E,MURPHY R K,et al.Dural arteriovenous fistula-induced thalamic dementia:report of 4cases[J].J Neurosurg,2016,124(6):1 752.
[17]张艳杰,石见,杜敢琴.典型颅内静脉窦血栓形成合并硬脑膜动静脉瘘1例[J].河南科技大学学报(医学版)医学版,2017,35(1):60-62.
[18]李桂林,马永杰,任健,等.近端血流阻断增压技术栓塞岩尖部硬脑膜动静脉瘘[J].中国脑血管病杂志,2016,13(7):365-368.
[19]宋操,金恒伟,刘佳,等.经同侧岩下窦栓塞双侧海绵窦区硬脑膜动静脉瘘一例报道[J].中华神经创伤外科电子杂志,2017,(5):309-311.
[20]文军,段传志,黄理金,等.应用Onyx联合弹簧圈栓塞海绵窦治疗海绵窦区硬脑膜动静脉瘘的经验探讨[J].中华神经医学杂志,2015,14(5):501-505.
[21]李嘉楠,李强,冯明陶,等.静脉窦内球囊保护下Onyx栓塞侧窦区硬脑膜动静脉瘘的随访分析[J].中国脑血管病杂志,2017,14(3):149-154.