Song Dong-Lei, Leng Bing, Xu Bin, Wang Qi-Hong, Chen Xian-Cheng, Zhou Liang-Fu
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Wai Ke Za Zhi. 2007 Feb 15;45(4):223-5.
To report our clinical experience of using Onyx, a new liquid embolic agent, to treat cerebral arteriovenous malformations (AVMs) as well as its efficacy.
Seventy cases were placed with 6F sheath in the femoral artery after Seldinger puncture and 6F guiding catheter was introduced into the internal carotid artery or vertebral artery, then a microcatheter was navigated into the nidus of AVMs. Slow injection of Onyx under fluoroscopic control was performed to embolize cerebral AVMs using the "plug and push" technique.
Thirteen AVM cases (18.6%) were totally occluded by Onyx and 5 cases of which didn't recurrence at 6-month after operation. Thirty-eight cases (54.3%) were subtotally occluded, while another 19 cases (27.1%) were partially embolized. Severe cerebral hemorrhage occurred in 4 cases, 2 of which had mild to severe hemiplegia after operation, and one died. Mild hemiplegia was also found in 1 case due to functional area embolization, and visual field deficit in 2 cases.
Onyx has unique and distinctive superiority in treating cerebral AVMs. Nonetheless, the correct embolization technique should be learned to achieve good clinical results and avoid complications.
报告我们使用新型液体栓塞剂Onyx治疗脑动静脉畸形(AVM)的临床经验及其疗效。
70例患者经Seldinger穿刺在股动脉置入6F鞘,将6F引导导管引入颈内动脉或椎动脉,然后将微导管导航至AVM的病灶内。在透视控制下缓慢注射Onyx,采用“栓塞并推注”技术栓塞脑AVM。
13例AVM患者(18.6%)被Onyx完全闭塞,其中5例术后6个月无复发。38例(54.3%)为次全闭塞,另有19例(27.1%)为部分栓塞。4例发生严重脑出血,其中2例术后出现轻至重度偏瘫,1例死亡。1例因功能区栓塞出现轻度偏瘫,2例出现视野缺损。
Onyx在治疗脑AVM方面具有独特的优势。尽管如此,应掌握正确的栓塞技术以取得良好的临床效果并避免并发症。