Sheng Li, Baomin Li, Jun Wang, Xiangyu Cao, Xiaofang Gu, Liping Guo
Department of Interventional Radiology, the General Hospital of PLA; Beijing, China.
Interv Neuroradiol. 2005 Oct 5;11(Suppl 1):119-24. doi: 10.1177/15910199050110S115. Epub 2005 Oct 27.
The high risk cerebral AVM can do great harm to people in case of hemorrhage .The goal of aathis paper is to discuss the characters of images and the technical manipulate of endovascular embolization for high risk cerebral AVM with bleeding. Fifty-six cases of high risk cerebral AVM with bleeding were confirmed by CT?MRI?and approved by whole cerebral DSA. Depended on the nidus of AVM, the superselective endovascular embolization with NBCA or embolization combined with radiological surgery was chosen. The nidus was eliminated for 100% in 36 cases after embolization for 1 to 3 processes. The rebleeding was found in 2 cases with new growth and survival aneurysm in nidus during the following period and treatment with Y-knife, and cured by second embolization. These are the main causes of brain bleeding composed of aneurysm and aneurysmlike dilation beside and located at the nidus, fine draining veins, and growth in ventricles. It is the favourable for the preference to eliminate the aneurysm in AVM during embolization to prevent brain from bleeding.
高风险脑动静脉畸形(AVM)一旦出血会对人体造成极大危害。本文旨在探讨出血性高风险脑AVM的影像学特征及血管内栓塞的技术操作。56例出血性高风险脑AVM经CT、MRI确诊,并经全脑DSA证实。根据AVM的病灶,选择用NBCA进行超选择性血管内栓塞或栓塞联合放射外科治疗。栓塞1至3个疗程后,36例病灶被100%消除。随访期间,2例出现新生长且病灶内有存活动脉瘤,经γ刀治疗,再次栓塞治愈。这些是脑出血的主要原因,包括病灶旁及位于病灶处的动脉瘤和类动脉瘤样扩张、细小引流静脉以及在脑室内生长。栓塞时优先消除AVM中的动脉瘤有利于预防脑出血。