用聚乙烯醇颗粒栓塞脊髓硬脊膜动静脉瘘：14例患者的经验
Embolization of spinal dural arteriovenous fistula with polyvinyl alcohol particles: experience in 14 patients.
作者信息
Nichols D A, Rufenacht D A, Jack C R, Forbes G S
机构信息
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
出版信息
AJNR Am J Neuroradiol. 1992 May-Jun;13(3):933-40.
PURPOSE
To assess the effectiveness, initial and long term, of embolization using polyvinyl alcohol particles (PVA) particles in patients with spinal dural arteriovenous fistulas (SDAVF).
METHODS
The initial treatment in 14 patients with SDAVF was embolization with PVA particles. Postembolization occlusion of the SDAVF was documented angiographically in all cases.
RESULTS
All 14 patients initially showed an improvement in clinical symptoms, but the neurologic status of 11 patients subsequently deteriorated. Of the 11 patients who had recurrence of symptoms, nine had angiographically proven recurrences of their SDAVF while two had negative follow-up of spinal angiography. PVA embolization is ineffective for the treatment of SDAVF and is not without risk.
CONCLUSION
On the basis of a literature review of the other two alternative treatments (operation or liquid adhesive embolization) available for SDAVF and our preliminary experience with N-butyl cyanoacylate (NBCA) embolization, we suggest that NBCA embolization be the initial treatment of choice for SDAVF; if that procedure is not possible, or is unsuccessful, then operation is recommended.
目的
评估使用聚乙烯醇（PVA）颗粒栓塞治疗脊髓硬脊膜动静脉瘘（SDAVF）患者的短期和长期有效性。
方法
14例SDAVF患者的初始治疗为PVA颗粒栓塞。所有病例均通过血管造影记录栓塞后SDAVF的闭塞情况。
结果
所有14例患者最初临床症状均有改善，但随后11例患者的神经功能状态恶化。在症状复发的11例患者中，9例经血管造影证实SDAVF复发，2例脊髓血管造影随访结果为阴性。PVA栓塞治疗SDAVF无效且并非没有风险。
结论
基于对SDAVF可用的其他两种替代治疗方法（手术或液体粘合剂栓塞）的文献综述以及我们使用氰基丙烯酸正丁酯（NBCA）栓塞的初步经验，我们建议NBCA栓塞是SDAVF的首选初始治疗方法；如果该 procedure 不可行或不成功，则建议进行手术。
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