Pelz D M, Fox A J, Viñuela F, Drake C C, Ferguson G G
Department of Radiology, University Hospital, University of Western Ontario, London, Canada.
AJNR Am J Neuroradiol. 1988 Jul-Aug;9(4):757-64.
The role of embolization in the management of brain arteriovenous malformations remains controversial. The benefits of embolization alone are not clear and surgical removal may be technically difficult or impossible in many cases. In an attempt to facilitate surgical removal, we performed preoperative embolization in 15 cases using a mixture of isobutyl-2 cyanoacrylate and glacial acetic acid. In one case, a mixture of polyvinyl alcohol particles, microfibrillar collagen, and 30% ethanol was used. In 10 of these cases the surgeon felt that the embolization significantly aided the operative removal by decreasing blood loss, reducing the size of draining veins, and removing portions of the nidus itself. In no patient did the embolization result in an unanticipated significant neurologic deficit. The major role for embolization in the management of brain arteriovenous malformations may be as an aid to surgical removal.
栓塞术在脑动静脉畸形治疗中的作用仍存在争议。单独进行栓塞术的益处尚不明确，而且在许多情况下手术切除在技术上可能困难或无法实现。为了便于手术切除，我们对15例患者使用异丁基 - 2 - 氰基丙烯酸酯和冰醋酸的混合物进行了术前栓塞。在1例患者中，使用了聚乙烯醇颗粒、微纤维胶原和30%乙醇的混合物。在其中10例患者中，外科医生认为栓塞术通过减少失血、缩小引流静脉大小以及去除畸形血管团本身的部分组织，显著有助于手术切除。没有患者因栓塞术导致意外的严重神经功能缺损。栓塞术在脑动静脉畸形治疗中的主要作用可能是辅助手术切除。
