Hirabuki N, Mitomo M, Miura T, Hashimoto T, Kawai R, Kozuka T
Department of Radiology, Osaka University Medical School, Japan.
Acta Radiol. 1990 Mar;31(2):197-201.
Nine patients with dural arteriovenous malformations (AVMs) in the region of the cavernous sinus were treated by means of external carotid artery (ECA) embolization using polyvinyl alcohol. All AVMs received vascular supply from both the ECA and the internal carotid artery. Seven cases were clinically cured after embolization, while 2 cases with cortical venous drainage and high flow through the shunt were not completely cured. Venous thrombosis was observed in 5 cases before and in 9 after embolization. In 6 cases the drainage pattern changed owing to venous thrombosis. Complete thrombosis of the cavernous sinus was found on a follow-up angiography in 2 cases. Formation of venous thrombosis and occlusion of feeding arteries are crucial factors for success of ECA embolization. Dural AVMs with cortical venous drainage and high flow cannot be relieved by ECA embolization alone owing to difficulty in obtaining thrombosis of the veins.
9例海绵窦区硬脑膜动静脉畸形（AVM）患者接受了使用聚乙烯醇的颈外动脉（ECA）栓塞治疗。所有AVM均接受来自ECA和颈内动脉的血管供血。7例患者栓塞后临床治愈，而2例伴有皮质静脉引流且分流处血流高的患者未完全治愈。栓塞前5例观察到静脉血栓形成，栓塞后9例观察到静脉血栓形成。6例患者因静脉血栓形成导致引流模式改变。随访血管造影发现2例海绵窦完全血栓形成。静脉血栓形成和供血动脉闭塞是ECA栓塞成功的关键因素。由于难以使静脉形成血栓，仅靠ECA栓塞无法缓解伴有皮质静脉引流且血流高的硬脑膜AVM。
