Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China.
Interventional Neuroradiology department, Beijing Neurosurgical Institute, Beijing, China.
Stroke Vasc Neurol. 2021 Jun;6(2):260-266. doi: 10.1136/svn-2020-000482. Epub 2020 Dec 9.
The safety and effectiveness of endovascular treatment for non-Galenic pial arteriovenous fistula (NGPAVF) is inadequately known. The aim of this study is to explore the role of endovascular embolisation for curative treatment of NGPAVF.
Patients with NGPAVF underwent endovascular treatment from January 2011 to November 2019 in our institution were retrospectively reviewed. Demographics, clinical information, treatment details and clinical outcomes were collected. Factors associated with clinical outcomes were statistically analysed.
Twenty patients were included, with a total of 22 (2 patients have 2 fistulas) lesions. A total of 25 procedures were performed and 5 patients underwent 2 procedures. Follow-up ranged from 3 to 84 months (mean=34.5 months). Thirteen (59.1%) lesions in 12 (60.0%) patients acquired immediate occlusion after initial treatment (immediately occluded group) and follow-up confirmed the complete obliteration. A total of 17 (77.3%) lesions in 15 (75.0%) patients were cured at last follow-up. The maximal diameter of feeding arteries (p=0.04) and the maximal diameter of the varix (p=0.01) in immediately occluded group was smaller than non-immediately occluded group. The number of feeding artery (p=0.004) and the maximal diameter of the varix (p<0.001) were much smaller in curative group than non-curative group. Seven patients suffered procedure-related complications. No patients had an increased Modified Rankin Scale (mRS) and all patients had favourable clinical outcome (mRS ≥2) at last follow-up.
Endovascular therapy plays an important role in curative treatment of NGPAVF. Patients with less feeding arteries and small varix may be easier to be cured by endovascular embolisation.
腔内治疗非 Galenic 脑表面动静脉瘘（NGPAVF）的安全性和有效性尚不清楚。本研究旨在探讨血管内栓塞治疗 NGPAVF 的作用。
回顾性分析 2011 年 1 月至 2019 年 11 月我院收治的 NGPAVF 患者的临床资料。收集患者的一般资料、临床资料、治疗细节及临床转归。统计分析与临床转归相关的因素。
共纳入 20 例患者，共 22 处（2 例患者各有 2 处瘘）病变。共进行 25 次治疗，5 例患者进行 2 次治疗。随访时间为 3 至 84 个月（平均 34.5 个月）。初始治疗后 13 处（59.1%）病变即刻闭塞（即刻闭塞组），随访证实完全闭塞。15 例（75.0%）患者的 17 处病变（77.3%）最终治愈。即刻闭塞组的供血动脉最大直径（p=0.04）和静脉瘤最大直径（p=0.01）小于非即刻闭塞组。治愈组的供血动脉数量（p=0.004）和静脉瘤最大直径（p<0.001）明显小于未治愈组。7 例患者发生与治疗相关的并发症。末次随访时，所有患者 mRS 评分均无增加（mRS≥2），均获得良好的临床转归。
血管内治疗在 NGPAVF 的治愈治疗中起着重要作用。供血动脉较少和静脉瘤较小的患者可能更容易通过血管内栓塞治愈。
