Fang Yi-Bin, Byun Jun-Soo, Liu Jian-Min, Krings Timo, Pereira Vitor M, Brinjikji Waleed
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China -
Division of Neuroradiology and Neurosurgery, Toronto Western Hospital and University Health Network, University of Toronto, Toronto, ON, Canada -
J Neurosurg Sci. 2019 Aug;63(4):468-472. doi: 10.23736/S0390-5616.18.04342-4. Epub 2018 Feb 13.
The safety and efficacy of transvenous embolization of brain arteriovenous malformations (AVM) remains relatively poorly understood. We performed a systematic review of the literature to determine outcomes of transvenous embolization of brain AVMs.
Data sources include Ovid MEDLINE, Ovid EMBASE and the Web of Science. All case series with four or more patients receiving transvenous embolization of brain AVMs published before September 2017 were included.
A total of 8 series with 66 patients were included. All-cause mortality rate was 6.0% (95% CI: 0.0-11.0%). There were no cases of treatment related mortality. Overall good functional outcome rates were 89.0% (95% CI: 82.0-96.0%). Complete occlusion rates were 96.0% (95% CI: 91.0-100.0%). Technical complications rates were 8.0% (95% CI: 2.0-14.0%). Additional treatment rates were 6.0% (95% CI: 0.0-11.0%).
Patients receiving transvenous embolization of AVMs experience good long-term clinical outcomes in nearly 90% of highly selected cases. Further large case series are needed to confirm the result.
经静脉栓塞治疗脑动静脉畸形（AVM）的安全性和有效性仍相对了解不足。我们对文献进行了系统综述，以确定经静脉栓塞治疗脑AVM的结果。
数据来源包括Ovid MEDLINE、Ovid EMBASE和科学网。纳入所有在2017年9月之前发表的、有4例或更多患者接受经静脉栓塞治疗脑AVM的病例系列。
共纳入8个系列66例患者。全因死亡率为6.0%（95%CI：0.0 - 11.0%）。无治疗相关死亡病例。总体良好功能结局率为89.0%（95%CI：82.0 - 96.0%）。完全闭塞率为96.0%（95%CI：91.0 - 100.0%）。技术并发症发生率为8.0%（95%CI：2.0 - 14.0%）。额外治疗率为6.0%（95%CI：0.0 - 11.0%）。
在近90%经过严格挑选的病例中，接受AVM经静脉栓塞治疗的患者有良好的长期临床结局。需要进一步的大型病例系列来证实这一结果。
