Luo Chao-Bao, Teng Michael Mu-Huo, Chang Feng-Chi, Chang Cheng-Yen
Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, ROC.
J Chin Med Assoc. 2006 Feb;69(2):80-5. doi: 10.1016/S1726-4901(09)70118-2.
This study reports our experience in performing transarterial Guglielmi detachable coil (GDC) embolization for intracranial high-flow arteriovenous fistulas (AVFs) and evaluates its efficacy and safety.
Over 3 years, 13 patients with 14 intracranial high-flow AVFs had been managed by transarterial GDC embolization in our institution. There were 6 men and 7 women, with a mean age of 27 years. Of these 14 AVFs, 8 were traumatic carotid-cavernous fistulas (TCCFs); 5 were AVFs at the frontal, temporal, parieto-occipital lobes, or associated with arteriovenous malformation (n = 3); 1 was a tentorium AVF.
All of these high-flow AVFs were successfully occluded by a single session of transarterial GDC embolization. In 8 patients with TCCFs, the nearby parent arteries were preserved. The average number of coils was 8 and the average length was 126 cm. All AVF-related symptoms resolved immediately or gradually on clinical follow-up. No significant procedure-related neurologic complication or recurrent AVF was seen. All 13 patients were followed up clinically for an average of 16 months (range, 6-25 months).
Transarterial GDC embolization is a useful method in the treatment of intracranial high-flow AVFs. GDC affords more control in the placement of coils and proved both efficient and safe in the management of intracranial high-flow AVFs.
本研究报告了我们对颅内高流量动静脉瘘（AVF）进行经动脉 Guglielmi 可脱性弹簧圈（GDC）栓塞的经验，并评估其有效性和安全性。
在 3 年多的时间里，我们机构对 13 例患有 14 个颅内高流量 AVF 的患者进行了经动脉 GDC 栓塞治疗。其中男性 6 例，女性 7 例，平均年龄 27 岁。在这 14 个 AVF 中，8 个是创伤性颈内动脉海绵窦瘘（TCCF）；5 个位于额叶、颞叶、顶枕叶或与动静脉畸形相关的 AVF（n = 3）；1 个是小脑幕 AVF。
所有这些高流量 AVF 均通过单次经动脉 GDC 栓塞成功闭塞。在 8 例 TCCF 患者中，保留了附近的供血动脉。平均使用弹簧圈数量为 8 个，平均长度为 126 cm。所有与 AVF 相关的症状在临床随访中立即或逐渐消失。未观察到与手术相关的严重神经并发症或复发性 AVF。13 例患者均接受了平均 16 个月（范围 6 - 25 个月）的临床随访。
经动脉 GDC 栓塞是治疗颅内高流量 AVF 的一种有效方法。GDC 在弹簧圈放置方面提供了更好的控制，并且在颅内高流量 AVF 的治疗中证明是有效且安全的。
