FLOW VELOCITY AND PRESSURE MEASUREMENTS IN SPINAL DURAL ARTERIOVENOUS-FISTULAS
FLOW VELOCITY AND PRESSURE MEASUREMENTS IN SPINAL DURAL ARTERIOVENOUS-FISTULAS
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DOI：
10.1007/bf00309983
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发表时间：
1994-01-01
影响因子：
2.8
通讯作者：
THRON, A
中科院分区：
文献类型：
--
作者：
HASSLER, W;THRON, A
在10例硬脊膜动静脉瘘(AVF)手术中，对血流速度和血管内压进行了测量。使用微型多普勒探头记录血流速度。用小针测量拔除AVF前后引流静脉的血管内压变化。将二氧化碳分压在20~60 mm Hg之间变化，观察供血脊髓动脉的血流速度，以观察AVF阻断前后脊髓组织周围血管壁的血管舒缩反应性。硬脑膜动静脉曲张的血流速度不如脑血管瘤的高。此外，通常表现为舒张期末期血流速度降低，作为血管阻力增加的征象，从而证明椎管内静脉流出受损。切除局部瘘管后，供血和引流脊髓的血管循环得到改善。在原有的受体静脉中，无法记录到进一步的血流。硬脑膜动静脉瘘的静脉压约为全身动脉压的70%。在血管造影上表现为高分流量的瘘管，与低流量的瘘管相比，只有中度的静脉压升高和更明显的压力下降。AFV摘除前后脊髓供血血管的二氧化碳反应性均正常。
During ten operations for spinal dural arterio-venous fistulas (AVF), intraoperative measurement of flow velocity and intravascular pressure was performed. Flow velocities were recorded using a miniaturized Doppler probe. Intravascular pressure changes in the draining veins beofre and after AVF removal was measured with small needles. Varying the PCO2 between 20 mm Hg and 60 mm Hg, the flow velocities in arteries supplying the spinal cord were investigated so that the vasomotoric reactivity of the peripheral vessel wall in cord tissue was investigated before and after AVF occlusion. The flow velocities in dural AVF feeders were not as high as those known from cerebral angioma feeders. In addition, they often showed lowered end-diastolic flow velocity as a dign of increased vascular resistance, thus proving impaired venous outflow from the spinal canal. After excision of the local fistula, the vessels supplying and draining the spinal cord showed improved circulation. In the former recipient veins, no further flow could be recorded.The venous pressure in dural AVF was about 70% of the systemic arterial pressure. Fistulas presenting a high shunt volume on angiography showed only moderately increased venous pressure and a more pronounced pressure drop after fistula occlusion as compared with low-volume fistulas. The CO2 reactivity of vessels supplying the spinal cord was normal before and after AFV removal.