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目的探讨经动脉途径以低浓度氰基丙烯酸正丁酯栓塞治疗硬脑膜动静脉瘘的技术方法和疗效。方法采用低浓度(10%~20%)氰基丙烯正丁酯(NBCA)经供血动脉对18例不同部位硬膜动静脉瘘患者进行栓塞治疗。18例患者中海绵窦区硬膜动静脉瘘12例,顶部硬膜动静脉瘘6例。该技术的关键操作方法是将低浓度NBCA注入静脉端使之闭塞并反流入其他供血动脉。结果18例患者中17例在栓塞后达到解剖治愈,术后临床症状消失。另1例通过海绵窦区硬膜动静脉瘘栓塞后一度症状好转,2d后症状加重,复查造影发现静脉未完全闭塞,回流静脉发生改变,经压颈10d后症状明显好转。结论经动脉途径以低浓度NBCA栓塞治疗硬脑膜动静脉瘘对于有些病例是较好的选择,其特点是低廉、快捷,疗效满意。
Objective To investigate the technical method and efficacy of transarterial approach for the treatment of dural arteriovenous fistula with low concentration of n-butyl cyanoacrylate embolization. Methods Eighteen patients with different sites of dural arteriovenous fistula were treated with low-concentration (10% -20%) n-butyl cyanoacrylate (NBCA) through the feeding artery. In 18 cases, 12 cases of dural arteriovenous fistula in cavernous sinus and 6 cases of dural arteriovenous fistula in the top. The key technique for this technique is to inject low concentrations of NBCA into the venous end to occlude and back-flow into other feeding arteries. Results Among the 18 patients, 17 cases were cured by embolization and the clinical symptoms disappeared after operation. Another case of dural cavernous fistula cavernous sinus fistula improved the symptoms, 2d after the symptoms aggravated, review the angiography found that the vein is not completely occluded, reflux venous changes after 10 days after compression neck symptoms improved significantly. Conclusions The treatment of dural arteriovenous fistula with low concentration of NBCA via arterial approach is a good choice for some cases, which is characterized by low cost, quick response and satisfactory curative effect.