Division of Interventional Neuroradiology, Department of Medical Imaging, Prince of Wales Hospital, Barker Street, Randwick, New South Wales 2031, Australia.
J Clin Neurosci. 2010 Oct;17(10):1267-70. doi: 10.1016/j.jocn.2010.01.041. Epub 2010 Jul 15.
We investigated the incidence of the trigeminocardiac reflex (TCR) during ethylene vinyl alcohol copolymer (Onyx Liquid Embolic System, ev3 Neurovascular, Irvine, CA, USA) embolisation of intracranial dural arteriovenous fistulas (DAVFs) and evaluated the post-procedural recovery of these patients. Between June 2006 and July 2009, 21 patients (11 females, 10 males) with a mean age of 61years (range: 25-85years) underwent 28 Onyx embolisations of intracranial DAVFs at our institution. The case histories of these patients were reviewed retrospectively. A TCR occurred in three (10.7%) of the embolisations, with bradycardia lower than 60 beats/minute and a drop in mean arterial blood pressure of 20% or more. The reflex was blunted promptly with intravenous atropine, and follow-up of these patients showed no complications that might have been directly related to it. The TCR may occur during Onyx embolisation of intracranial DAVFs. Recognition of this phenomenon allows for early detection and appropriate intraoperative management.
我们研究了在颅内硬脑膜动静脉瘘（DAVF）的乙烯基醇共聚物（Onyx 液体栓塞系统，ev3 神经血管，欧文，加利福尼亚州，美国）栓塞过程中三叉心反射（TCR）的发生率，并评估了这些患者的术后恢复情况。2006 年 6 月至 2009 年 7 月，我们机构对 21 名患者（11 名女性，10 名男性）进行了 28 次颅内 DAVF 的 Onyx 栓塞，这些患者的平均年龄为 61 岁（范围：25-85 岁）。回顾性分析这些患者的病史。在三次（10.7%）栓塞中发生了 TCR，表现为心动过缓低于 60 次/分钟，平均动脉血压下降 20%或更多。反射通过静脉内阿托品迅速减弱，对这些患者的随访显示没有可能与它直接相关的并发症。TCR 可能发生在颅内 DAVF 的 Onyx 栓塞过程中。识别这种现象可以进行早期发现和适当的术中管理。
