Fournier D, TerBrugge K G, Willinsky R, Lasjaunias P, Montanera W
Radiology Department, Toronto Western Hospital, Ontario, Canada.
J Neurosurg. 1991 Aug;75(2):228-33. doi: 10.3171/jns.1991.75.2.0228.
The authors report the results of treatment in 49 consecutive patients with brain arteriovenous malformations (AVM's) who underwent therapeutic embolization with liquid adhesive agents between 1984 and 1988 at the Toronto Western Hospital. Thirty-three patients had no other treatment and were followed up with angiography at 2 years and clinically from 2 to 6 years. Of the other 16 patients, 10 had adjunctive radiosurgery and six underwent surgical resection following embolization. Seven (14%) of the 49 patients had a morphological cure effected by embolization as evidenced on their 2-year follow-up angiograms: these have remained clinically stable. Twelve patients developed neurological deficits after embolization; eight (16% of the series) were transient and four (8%) were permanent. Two patients (4%) had a delayed hemorrhage after incomplete obliteration of their malformations. Endovascular treatment resulted in clinical improvement in 15 (33%) of the other 46 patients. None of the patients who initially presented with hemorrhage had a rebleed following embolization. It is concluded that endovascular treatment with liquid embolic material can be an integral part of the multidisciplinary treatment protocol for patients with brain AVM's.
作者报告了1984年至1988年间在多伦多西部医院接受液体粘合剂治疗性栓塞的49例连续性脑动静脉畸形（AVM）患者的治疗结果。33例患者未接受其他治疗，在2年时进行血管造影随访，并在2至6年进行临床随访。在其他16例患者中，10例接受了辅助性放射外科治疗，6例在栓塞后接受了手术切除。49例患者中有7例（14%）在2年随访血管造影中显示栓塞实现了形态学治愈：这些患者临床保持稳定。12例患者在栓塞后出现神经功能缺损；8例（占该系列的16%）为短暂性，4例（8%）为永久性。2例患者（4%）在畸形未完全闭塞后出现延迟性出血。血管内治疗使其他46例患者中的15例（33%）临床症状改善。最初表现为出血的患者在栓塞后均未再出血。结论是，使用液体栓塞材料进行血管内治疗可以成为脑AVM患者多学科治疗方案的一个组成部分。
