A nonadhesive liquid embolic agent of ethylene vinyl alcohol copolymer and ethanol mixture for cerebral arteriovenous malformations - Clinical experience
A nonadhesive liquid embolic agent of ethylene vinyl alcohol copolymer and ethanol mixture for cerebral arteriovenous malformations - Clinical experience
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DOI：
10.1177/15910199040100s123
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发表时间：
2004-03-01
影响因子：
1.7
通讯作者：
Ushio, Y
中科院分区：
文献类型：
--
作者：
Hamada, JI;Kai, Y;Ushio, Y
我们报告了使用新型非粘性液体栓塞剂（乙烯乙烯醇共聚物（EVAL）/乙醇混合物）治疗人类动静脉畸形（AVM）的经验。1995年6月至2001年4月期间，57例确诊AVM的患者接受了EVAL/乙醇混合物栓塞。使用87个程序，包括一至三个阶段，我们栓塞了185供血动脉闭塞尽可能多的AVM。在荧光镜控制下重复注射可以顺利进行，而不会遇到水泥的导管在血管壁中。在87个程序进行的57例患者中，7例（8.0%）的程序在6例患者产生新的栓塞后症状。这些症状在7例手术中的4例手术后数小时或数天内消退; 3例栓塞手术后仍存在永久性神经功能缺损（3.4%）。57例患者中，3例行栓塞后放射外科治疗，54例行显微外科根治术，54例标本的组织学检查显示栓塞腔内有轻度炎症反应，中膜和外膜无炎症反应。在接受放射外科手术三年后获得的随访血管造影片显示，所有三名患者的病灶都已完全消失。EVAL/乙醇混合物易于处理，似乎是AVM术前栓塞的有效和安全的栓塞剂。
We report our experience using our new non-adhesive liquid embolic agent, an ethylene vinyl alcohol copolymer (EVAL)/Ethanol mixture, to treat human arteriovenous malformations (AVM). Between June 1995 and April 2001, 57 patients with confirmed AVM underwent embolization with the EVAL/Ethanol mixture. Using 87 procedures consisting of one to three stages, we embolized 185 feeding arteries to occlude as much of the AVM as possible. Repeated injections under fluoroscopic control could be performed smoothly without encountering cementing of the catheter in the vessel wall.Among 87 procedures undertaken in 57 patients, seven (8.0%) procedures in six patients produced new postembolization symptoms. Resolution of these symptoms occurred within hours or days following four of the seven procedures; permanent neurological deficits remained after three embolization procedures (3.4%). Of the 57 patients, three underwent postembolization radiosurgery, 54 were radically treated with microsurgical extirpation.Histopathological examinations of the 54 specimens disclosed mild inflammation within the embolized lumen without inflammatory reactions in the media or adventitia. Follow-up angiograms obtained three years after they underwent radiosurgery showed that in all three patients the nidus had completely disappeared.The EVAL/Ethanol mixture is handled easily and appears to be an effective and safe embolic agent for the preoperative embolization of AVM.