Preembolization functional evaluation in brain arteriovenous malformations: the ability of superselective Amytal test to predict neurologic dysfunction before embolization.
Preembolization functional evaluation in brain arteriovenous malformations: the ability of superselective Amytal test to predict neurologic dysfunction before embolization.
复制标题
脑动静脉畸形的栓塞前功能评估：超选择性 Amytal 试验在栓塞前预测神经功能障碍的能力。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
J. Bentson
中科院分区：
文献类型：
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作者：
R. Rauch;F. Viñuela;J. Dion;G. Duckwiler;Edwin;Amos;S. Jordan;Neil A. Martin;M. Jensen;J. Bentson
目的
描述幕上AVM栓塞后神经功能障碍的发生率，并将结果与栓塞前Amytal试验结果相关联。
材料和方法
回顾性分析了30例清醒患者Amytal试验后147例幕上AVM栓塞的数据。
结果
在Amytal试验阳性后进行的5次栓塞中，2次发生神经系统并发症。Amytal试验阴性后立即进行的82次单次栓塞与神经系统并发症无关。其余栓塞是多个栓塞系列的一部分，每个栓塞系列从Amytal试验开始，随后进行多次栓塞，但没有导管移动或重复Amytal试验。由于该系列中的任何既往栓塞可能会降低AVM的积液效应，因此在该系列中稍后输送的栓塞剂可能会到达Amytal试验未完全测试的功能性脑组织。因此，单独考虑重复栓塞（之前未立即进行Amytal试验）。在60例重复栓塞中，6例（10%）与神经系统并发症相关。
结论
当AVM栓塞时，重复Amytal试验可能会检测到储槽效应的丧失。我们的结论是，使用超选择性Amytal试验的数据增加了AVM栓塞的安全性，并且当计划对血管进行连续栓塞时，重复Amytal试验可能是有价值的。
PURPOSE
To describe the incidence of neurologic dysfunction following embolization of supratentorial AVMs, and to correlate findings with results of preembolization Amytal tests.
MATERIALS AND METHODS
Data from 147 embolizations of supratentorial AVMs following Amytal tests in 30 awake patients were analyzed retrospectively.
RESULTS
Of five embolizations done after a positive Amytal test, two were followed by neurologic complications. Eighty-two embolizations done as single embolizations immediately after a negative Amytal test were associated with no neurologic complications. The remaining embolizations were parts of multiple series of embolizations, each beginning with an Amytal test and followed by a number of embolizations without catheter movement or repeat Amytal testing. Since any prior embolization in the series might reduce the sump effect of the AVM, embolic agent delivered later in the series could potentially reach functional brain tissue not fully tested by the Amytal test. Therefore, repeat embolizations (not immediately preceded by an Amytal test) were considered separately. In 60 repeat embolizations, six (10%) were associated with some neurologic complication.
CONCLUSIONS
Repeat Amytal testing might detect the loss of sump effect as the AVM is embolized. We conclude that use of data from superselective Amytal tests adds to the safety of AVM embolizations and that repeat Amytal testing potentially could be valuable when serial embolization of a vessel is planned.