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目的 探讨新型液态栓塞剂Onyx栓塞脑动静脉畸形的技术要点和临床效果。 方法 对21例脑动静脉畸形患者采用Seldinger技术在股动脉内置入6 F鞘,6 F导引导管进入颈内动脉或椎动脉,以Ultraflow微导管超选择进入畸形团内,采用“阻断和前推技术”长时间缓慢注射Onyx栓塞脑动静脉畸形。本组患者中有13例动静脉畸形位于功能区(运动区、语言区、视觉中枢),6例位于大脑半球深部,2例位于小脑半球。畸形团大小为3 cm的9例,3-6 em的8例,6 cm以上的4例。 结果 治疗后脑动静脉畸形的体积缩小程度为20％-100％。初期因使用Onyx经验不足,在拔出微导管时有2例患者发生严重脑出血,行外科手术救治,其余19例患者无严重并发症。 结论 Onyx栓塞技术可作为治疗体积较大、位于大脑深部及功能区脑动静脉畸形的重要方法之一,长期疗效有待随访结果的验证。
Objective To investigate the technical points and clinical effects of Onyx embolization of cerebral arteriovenous malformations. Methods Twenty - one patients with cerebral arteriovenous malformations were treated with Seldinger technique. 6F sheath was inserted into the femoral artery. Catheter was guided into the internal carotid artery or vertebral artery by Ultrafine microcatheter. And advance technology "for a long time slowly onyx embolism cerebral arteriovenous malformations. Thirteen patients had arteriovenous malformations in the functional area (motor area, language area, visual center), 6 in the deep part of the cerebral hemisphere and 2 in the cerebellar hemisphere. 9 cases of deformity size of 3 cm, 3-6 cm in 8 cases, 4 cm above 6 cm. Results After treatment, the volume of cerebral arteriovenous malformations decreased by 20% -100%. Inadequate initial experience with Onyx resulted in severe brain hemorrhage in 2 of the patients when the microcatheter was removed and was surgically removed. The remaining 19 patients had no serious complications. Conclusion Onyx embolization can be used as one of the important methods for the treatment of cerebral arteriovenous malformations with large volume, deep brain and functional area. The long-term efficacy remains to be verified by follow-up results.