摘要
目的总结探讨Onyx胶在脑动静脉畸形（AVM）栓塞治疗中的应用及栓塞后治疗。方法共21例DSA确诊的脑AVM患者，采用Onyx胶治疗；根据栓塞程度行栓塞后处理（随访、立体定向放射治疗、显微手术等）。结果影像学完全栓塞8例（38％），其中术后少量蛛网膜下腔出血1例；次全栓塞4例（19％），1例术后重度脑水肿去骨瓣后因颅内感染自动出院失访，随访观察1例，伽玛刀治疗2例；部分栓塞9例（钙％），其中5例手术完全切除，2例伽玛刀治疗，另2例随访观察，其中1例术后3个月出现脑室内出血。结论Onyx液态栓塞剂有较好的弥散性和可控性，能有效改善脑AVM的栓塞效果，对次全栓塞者可选择随访观察或伽玛刀治疗，部分栓塞者应首先考虑手术切除。
Objective To report our experience in the treatment of brain arteriovenous malformations （BAVMs） with Onyx and discuss the post -embolic management. Methods 21 BAVMs patients confirmed by angiography were embolized with Onyx and dealed with subsequent treatment （follow- up, stereotactie radiosurgery or mlerosurgery） according to the embolization results. Results Eight cases （38%） were completely obliterated after embolization while one case suffered a small subarachnoid hemorrhage. Four cases （ 19% ） were subtotally embolized while one patient suffered severe cerebral edema after embolization and further intracranial infection after decompressive craniectomy who was lost for follow -up, 2 patients had additional radiosurgery and 1 patient had follow - up. Nine patients （43%） were partially embolized, 5 patients had additional surgery, 2 patients had additional radiosurgery and 2 patients had follow -up （1 patient had intraventricular hemorrhage 3 months after embolization）. Conclusions Onyx is suitable in the embolization of BAVMs for its diffuse and controllable properties. Additional radiosurgery or follow -up is suggested after subtotal embolization and additional surgery should be firstly considered after partially embolization.
出处
《中华神经外科杂志》
CSCD
北大核心
2010年第4期341-343,共3页
Chinese Journal of Neurosurgery
基金
基金项目：浙江省教育厅资助项目（Y200803344）
关键词
ONYX
脑动静脉畸形
栓塞
Onyx
Brain arteriovenous malformations
Embolization
