Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations: experience with 101 cases.
Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations: experience with 101 cases.
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血管内栓塞联合手术治疗脑动静脉畸形101例体会
DOI：
10.3171/jns.1991.75.6.0856
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发表时间：
1991
影响因子：
4.1
通讯作者：
G. Debrun
中科院分区：
文献类型：
--
作者：
F. Viñuela;J. Dion;G. Duckwiler;N. Martin;P. Lylyk;A. Fox;D. Pelz;C. Drake;J. Girvin;G. Debrun
作者描述了他们对101例脑动静脉畸形（AVM）进行血管内栓塞治疗后手术切除的经验。53例患者出现颅内出血，35例出现癫痫发作。根据Spetzler和Martin的分类，2例AVM为I级，13例为II级，26例为III级，43例为IV级，17例为V级。五十六例AVM位于右半球，28例位于左半球，12例位于胼胝体，5例累及小脑。在50例病例中，通过栓塞实现了50%至75%的AVM病灶的术前闭塞，在31例病例中，该百分比增加到75%至90%。在97例（96%）患者中，获得了AVM的完全手术切除。术前血管内栓塞导致的死亡率在3.9%的病例中被分类为轻度，在6.9%的病例中被分类为中度，在1.98%的病例中被分类为重度。与栓塞相关的死亡率为0.9%。5.9%的病例术后即刻发病率被分类为轻度，10.8%为中度，5.9%为重度。5.9%的病例总体长期发病率为轻度，6.9%为中度，1.98%为重度。2例患者（1.98%）死于难治性术中出血，2例（1.98%）死于术后肺部并发症。
The authors describe their experience with 101 cerebral arteriovenous malformations (AVM's) treated by endovascular embolization followed by surgical removal. Fifty-three patients presented with intracranial hemorrhage and 35 had seizures. Based on the classification of Spetzler and Martin, two AVM's were Grade I, 13 were Grade II, 26 were Grade III, 43 were Grade IV, and 17 were Grade V. Fifty-six AVM's were in the right hemisphere, 28 were in the left hemisphere, 12 were in the corpus callosum, and five involved the cerebellum. In 50 cases, presurgical obliteration of 50% to 75% of the AVM nidus was achieved by embolization, and in 31 cases this percentage increased to between 75% and 90%. In 97 (96%) patients, complete surgical removal of the AVM was obtained. Morbidity resulting from preoperative endovascular embolization was classified as mild in 3.9% of the cases, moderate in 6.9%, and severe in 1.98%. The death rate related to embolization was 0.9%. The immediate postsurgical morbidity was classified as mild in 5.9% of the cases, moderate in 10.8%, and severe in 5.9%. The overall long-term morbidity was mild in 5.9% of the cases, moderate in 6.9%, and severe in 1.98%. Two patients (1.98%) died due to intractable intraoperative hemorrhage and two (1.98%) as a result of postsurgical pulmonary complications.
影响因子：
4.1
作者：
OJEMANN, G;OJEMANN, J;BERGER, M
通讯作者：
BERGER, M