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使用可解脱微导管和 Onyx 18 进行颅内动静脉畸形的血管内治疗。

Endovascular treatment of intracranial arteriovenous malformations using detachable-tip microcatheters and Onyx 18.

机构信息

Radiology Clinic, Inegol State Hospital, Bursa, Turkey.

Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey.

出版信息

Diagn Interv Imaging. 2019 Jun;100(6):353-361. doi: 10.1016/j.diii.2019.01.009. Epub 2019 Mar 8.

Abstract

PURPOSE

To evaluate clinical and imaging features before embolization, data of embolization procedure and outcome in patients with ruptured or unruptured intracranial arteriovenous malformation (AVM) who were treated by endovascular embolization using detachable-tip microcatheters and Onyx 18.

MATERIAL AND METHODS

Forty-three patients treated with endovascular embolization using a detachable-tip microcatheter and Onyx18 between January 2008 and April 2016 were evaluated. There were 27 men and 16 women with a mean age of 35.9±14.1years (range: 10-68years). Clinical and imaging features, embolization details and post-treatment findings were analyzed. Patients were divided into ruptured AVM and unruptured AVM groups. Death, complications and total embolization rates of each group were assessed.

RESULTS

Fifty-one embolization sessions were performed in 43 patients. Total embolization rate was 40% (17/43). There were significant relationships between AVM diameter and total embolization success and AVM diameter and complication rates. The degree of embolization was partial in all patients who had complications. Catheter retention and iatrogenic rupture were not observed in any procedure. No major neurologic deficit was seen in patients who had unruptured AVM and complications after treatment.

CONCLUSIONS

Our results show the efficacy of endovascular embolization of AVM using detachable-tip microcatheters and Onyx 18. A new AVM classification system based on AVM diameter for this embolization technique may be more predictive in terms of total embolization success and complication development.

摘要

目的

评估采用可解脱微导管和 Onyx 18 进行血管内栓塞治疗破裂或未破裂颅内动静脉畸形(AVM)患者的栓塞前临床和影像学特征、栓塞过程数据和结果。

材料与方法

评估了 2008 年 1 月至 2016 年 4 月期间采用可解脱微导管和 Onyx18 治疗的 43 例接受血管内栓塞治疗的患者。其中男 27 例,女 16 例,平均年龄 35.9±14.1 岁(10-68 岁)。分析了临床和影像学特征、栓塞细节和治疗后发现。将患者分为破裂性 AVM 和未破裂性 AVM 两组。评估每组的死亡率、并发症发生率和完全栓塞率。

结果

43 例患者共进行了 51 次栓塞治疗。总的栓塞成功率为 40%(17/43)。AVM 直径与完全栓塞成功率和 AVM 直径与并发症发生率之间存在显著关系。所有发生并发症的患者的栓塞程度均为部分栓塞。在任何手术过程中均未观察到导管保留和医源性破裂。治疗后有并发症的未破裂 AVM 患者和无并发症的患者均未出现重大神经功能缺损。

结论

我们的结果表明,采用可解脱微导管和 Onyx 18 进行 AVM 血管内栓塞是有效的。基于 AVM 直径的新 AVM 分类系统可能更能预测完全栓塞成功率和并发症的发生。

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