Gross Bradley A, Moon Karam, Mcdougall Cameron G
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Handb Clin Neurol. 2017;143:59-68. doi: 10.1016/B978-0-444-63640-9.00006-0.
Arteriovenous malformation (AVM) embolization can serve as a crucial adjunct before surgical resection, a partial approach to target high-risk features, or, rarely, as a curative approach for high-risk, surgically inaccessible lesions. Specifically, embolization is a welcome surgical adjunct to reduce the size of medium to large AVMs, to target perforator supply, and/or to target the deep portion of a nidus. In addition, a crucial role for embolization is the targeting of associated aneurysms, particularly in the setting of a ruptured lesion, regardless of the subsequent therapeutic modality. Rarely, a deep, small ruptured AVM that cannot be accessed surgically may be embolized with intent to cure. This chapter will review patient selection, technical nuances, and published results for AVM embolization. With appropriate patient selection and well-defined goals of embolization, the risk of procedural morbidity can be outweighed by its benefit.
动静脉畸形（AVM）栓塞可作为手术切除前的关键辅助手段，是针对高风险特征的部分治疗方法，或很少情况下作为高风险、手术难以触及病变的根治性方法。具体而言，栓塞是一种受欢迎的手术辅助手段，可用于减小中大型AVM的大小、针对穿支供血以及/或针对畸形灶的深部。此外，栓塞的关键作用是针对相关动脉瘤，特别是在病变破裂的情况下，无论后续采用何种治疗方式。很少有深部、小型破裂AVM无法通过手术触及，可进行栓塞以达到治愈目的。本章将回顾AVM栓塞的患者选择、技术细节和已发表的结果。通过适当的患者选择和明确的栓塞目标，手术并发症的风险可能会被其益处所抵消。
