Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure.
Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure.
复制标题
血管内氰基丙烯酸酯栓塞术完全闭塞颅内动静脉畸形：初步成功率和永久治愈率。
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
W. Poon
中科院分区：
文献类型：
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作者：
S. Yu;M. Chan;J. Lam;Patrick H. T. Tam;W. Poon
背景和目的
当目标是完全闭塞颅内动静脉畸形（AVM）病灶时，使用氰基丙烯酸酯栓塞进行血管内治疗是一种选择。我们的目的是评估中国人群中此类治疗的初始成功率和永久治愈率。
方法
1995年6月至1997年5月期间，27例颅内AVM患者接受了氰基丙烯酸酯血管内栓塞。26名患者患有脑AVM，1名患者患有小脑AVM。在10例患者中尝试了治愈性栓塞，其中1）病灶不大于3 cm，2）供血动脉数量不超过3个，3）病灶可通过导管头端进入。我们使用了流动导向微导管和造影剂中20-25%的氰基丙烯酸酯混合物。通过血管造影和临床观察长期结局。
结果
6例患者实现了完全栓塞。在尝试治疗性栓塞期间没有发生与手术相关的并发症。在17-32个月时进行的随访血管造影显示，6名患者在初始栓塞后AVM病灶完全闭塞。这些患者在治疗后5-7年仍无症状。最初完全栓塞的永久治愈率为100%（6/6）。以治愈为目的治疗的患者的血管内治愈成功率为60%（6/10）。总治愈率为22%（6/27）。
结论
氰基丙烯酸酯栓塞颅内AVM的总体初始治愈率为22%。完全栓塞的初始血管造影证据表明这些患者永久治愈。
BACKGROUND AND PURPOSE
Endovascular treatment with cyanoacrylate embolization is an option when complete obliteration of the nidus of an intracranial arteriovenous malformation (AVM) is the goal. Our purpose was to evaluate the rates of initial success and permanent cure of such treatment in a Chinese population.
METHODS
Twenty-seven consecutive patients with an intracranial AVM underwent endovascular embolization with cyanoacrylate between June 1995 and May 1997. Twenty-six patients had cerebral AVMs and one had a cerebellar AVM. Curative embolization was attempted in 10 patients in whom 1) the nidus was not larger than 3 cm, 2) the number of feeders did not exceed three, and 3) the nidus was accessible with the tip of the catheter. We used a flow-directed microcatheter and a 20-25% mixture of cyanoacrylate in contrast medium. Long-term outcomes were observed angiographically and clinically.
RESULTS
Complete embolization was achieved in six patients. No procedure-related complications occurred during attempted curative embolization. Follow-up angiography performed at 17-32 months showed complete obliteration of the AVM nidus in the six patients after initial embolization. These patients remained asymptomatic 5-7 years after treatment. The rate of permanent cure of the initially complete embolization was 100% (six of six). The success rate of endovascular cure for patients treated with curative intent was 60% (six of 10). The overall cure rate was 22% (six of 27).
CONCLUSION
The overall initial cure rate of intracranial AVM with cyanoacrylate embolization was 22%. Initial angiographic evidence of complete embolization indicated permanent cure in these patients.