动静脉畸形合并动脉瘤的分类建议及可能的治疗策略

Proposal of Classification of Aneurysms Coexisting with AVM and Possible Treatment Strategies.

作者信息

Lv Xianli, Wu Zhongxue, He Hongwei, Ge Huijian, Li Youxiang

机构信息

Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Interventional Neuroradiology Department, Beijing, China.

出版信息

Turk Neurosurg. 2016;26(2):229-33. doi: 10.5137/1019-5149.JTN.8600-13.1.

DOI:10.5137/1019-5149.JTN.8600-13.1

PMID:26956818

Abstract

AIM

To describe the classification of aneurysms coexisting with arteriovenous malformations (AVMs) and their endovascular treatment.

MATERIAL AND METHODS

Based on the basis of radiological findings and clinical features, 59 aneurysms coexisting with AVMs were classified into four different types: intranidal, flow-related (proximal and distal), and unrelated. These aneurysms were treated by endovascular techniques with or without AVM embolization. Clinical outcome was assessed using the modified Rankin Scale (mRS).

RESULTS

59 aneurysms coexisting with AVMs were found in 39 patients. There were 11 unrelated aneurysms, 18 proximal flow-related aneurysms, 11 distal flow-related aneurysms and 19 intranidal aneurysms. In the 11 unrelated aneurysms, 4 were caused subarachnoid hemorrhage. In 11 distal flow-related aneurysms near the AVM, 7 caused a major hemorrhage. Six of the 19 intranidal aneurysms presented with hemorrhage. In contrast, only 3 of the 14 proximal flow-related aneurysms on major feeding arteries caused hemorrhage.

CONCLUSION

Aneurysms coexisting with AVMs could be classified into four types and this classification may provide a rationale for endovascular treatment.

摘要

目的

描述与动静脉畸形（AVM）共存的动脉瘤的分类及其血管内治疗。

材料与方法

根据影像学表现和临床特征，将59例与AVM共存的动脉瘤分为四种不同类型：瘤巢内型、血流相关型（近端和远端）和无关型。这些动脉瘤采用血管内技术治疗，同时或不进行AVM栓塞。使用改良Rankin量表（mRS）评估临床结局。

结果

在39例患者中发现59例与AVM共存的动脉瘤。其中无关动脉瘤11例，近端血流相关动脉瘤18例，远端血流相关动脉瘤11例，瘤巢内动脉瘤19例。在11例无关动脉瘤中，4例导致蛛网膜下腔出血。在AVM附近的11例远端血流相关动脉瘤中，7例导致大出血。19例瘤巢内动脉瘤中有6例出现出血。相比之下，主要供血动脉上的14例近端血流相关动脉瘤中只有3例导致出血。