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目的 探讨α 氰基丙烯酸正丁酯 (NBCA)生物胶血管内栓塞治疗脑动静脉畸形的效果及技术要点。方法 对 4 6 9例脑动静脉畸形应用微导管技术 ,在数字减影血管造影监视下行血管内栓塞治疗。结果 成功栓塞 4 6 9例脑动静脉畸形 ,4 6 7例痊愈 ,2例死亡。 4 6 9例病人共行 110 8次栓塞 ,栓塞次数 1～ 8次 /例 ,平均 2 .3次。栓塞程度 :10 0 %栓塞 15 5例 ,90 %～ 10 0 %栓塞 93例 ,80 %～90 %栓塞 10 5例 ,70 %～ 80 %栓塞 78例 ,6 0 %～ 70 %栓塞 2 7例 ,栓塞 6 0 %以下 11例。栓塞后行γ 刀(或X 刀 )放射治疗 117例、手术切除 32例。并发症有脑梗死 1例 ,于尿激酶溶栓后恢复 ,脑出血 4例 ,2例导管断裂滞留畸形团内。结论 血管内栓塞治疗脑动静脉畸形是一种安全、可靠、有效的治疗手段。
Objective To investigate the effect and technical points of intracapsular embolization of α-cyano-n-butyl cyanoacrylate (NBCA) on cerebral arteriovenous malformations. Methods A total of 469 cases of cerebral arteriovenous malformations were treated with microcatheter technique and endovascular embolization with digital subtraction angiography. Results Cerebral arteriovenous malformations were achieved in 469 cases, 467 cases were cured and 2 cases died. 469 cases of patients with 1108 times embolization, embolization number 1 ~ 8 times / case, an average of 2.3 times. The degree of embolism: 10 0% embolism 15 5 cases, 90% ~ 100% embolism 93 cases, 80% ~ 90% embolization 105 cases, 70% ~ 80% embolization 78 cases, 60% ~ 70% embolism 27 cases , Embolism 6 0% following 11 cases. After embolization gamma knife (or X knife) radiotherapy in 117 cases, surgical resection in 32 cases. Complications of cerebral infarction in 1 case, urokinase thrombolysis recovery, cerebral hemorrhage in 4 cases, 2 cases of catheter rupture deformity within the Mission. Conclusion Endovascular embolization is a safe, reliable and effective treatment for cerebral arteriovenous malformations.