Huang Qinghai, Xu Yi, Hong Bo, Li Qiang, Zhao Wenyuan, Liu Jianmin
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Neurosurgery. 2009 Aug;65(2):287-92; discussion 292-3. doi: 10.1227/01.NEU.0000348298.75128.D0.
Tentorial dural arteriovenous fistula (DAVF) is an uncommon disease with a poor natural history. Management of tentorial DAVF remains controversial. This study reports the technique and results of transarterial embolization using Onyx (Micro Therapeutics Inc., Irvine, CA) in the treatment of a series of 14 patients with tentorial DAVFs.
We retrospectively reviewed the clinical and radiological data of 14 patients with tentorial DAVFs who were treated by transarterial embolization using Onyx at Shanghai Changhai Hospital between 2005 and 2008.
Twelve patients presented with subarachnoid or intraventricular hemorrhage. Complete cure was achieved in 11 patients after 1 procedure and in 1 patient after 2 procedures. Incomplete cure was obtained in the other 2 patients. One patient experienced vessel perforation; another had microcatheter retention. All of the patients recovered well, except 1 patient who died of severe infection caused by ventricular drainage. Clinical follow-up showed no rebleeding or worsening. Follow-up angiography in 8 patients with total occlusion demonstrated no recurrence.
These results suggest that transarterial embolization using Onyx is feasible and effective for the management of tentorial DAVFs.
天幕硬脑膜动静脉瘘（DAVF）是一种自然病程较差的罕见疾病。天幕DAVF的治疗仍存在争议。本研究报告了使用奥尼克斯（Micro Therapeutics Inc.，加利福尼亚州欧文市）经动脉栓塞治疗一系列14例天幕DAVF患者的技术及结果。
我们回顾性分析了2005年至2008年在上海长海医院接受奥尼克斯经动脉栓塞治疗的14例天幕DAVF患者的临床和影像学资料。
12例患者表现为蛛网膜下腔或脑室内出血。11例患者经1次治疗后完全治愈，1例患者经2次治疗后完全治愈。另外2例患者治疗未完全治愈。1例患者发生血管穿孔；另1例患者微导管滞留。除1例因脑室引流导致严重感染死亡的患者外，所有患者恢复良好。临床随访显示无再出血或病情恶化。8例完全闭塞患者的随访血管造影显示无复发。
这些结果表明，使用奥尼克斯经动脉栓塞治疗天幕DAVF是可行且有效的。
