Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China.
Br J Neurosurg. 2024 Jun;38(3):660-667. doi: 10.1080/02688697.2021.1950625. Epub 2021 Aug 11.
Flow-related aneurysms (FRAs) associated with cerebellar arteriovenous malformations (AVMs) are complicated, and their management is difficult. We performed a retrospective study to explore the efficacy and outcome of parent artery occlusion (PAO) for FRAs at the proximal segment of the main feeding arteries of cerebellar AVMs.
A retrospective study was performed for patients admitted for a cerebellar AVM between January 2015 and December 2019. Patients were included if (a) they presented with a ruptured or symptomatic FRA at the proximal segment of the main feeding arteries of the cerebellar AVM, (b) the cerebellar AVM did not bleed before admission, (c) the FRA was secured PAO of the parent feeding artery, and (d) the cerebellar AVM was not intentionally managed or embolized through other feeding arteries during hospitalization.
Eight patients aged between 27 and 72 (48.6 ± 14.3) years were identified. Eight ruptured and symptomatic FRAs at the proximal segment of the main feeding arteries of the cerebellar AVMs underwent PAO with coils or Onyx while preserving the arteries distal to the aneurysms. All the patients achieved a favorable recovery after treatment in a follow-up ranged from 8 to 48 months. One patient experienced FRA recurrence and underwent a second PAO.
PAO for FRAs at the proximal segment of the main feeding arteries of cerebellar AVMs is a feasible option. This method is effective in preventing re-rupture of the FRAs and relieving the symptoms in the short term, allowing sufficient time for the patients to receive subsequent treatment.
与小脑动静脉畸形（AVM）相关的血流相关性动脉瘤（FRA）较为复杂，其治疗具有一定难度。我们进行了一项回顾性研究，旨在探讨小脑 AVM 主要供血动脉近端 FRA 行母动脉闭塞（PAO）的疗效和结果。
对 2015 年 1 月至 2019 年 12 月期间收治的小脑 AVM 患者进行了回顾性研究。纳入标准为：（a）小脑 AVM 主要供血动脉近端破裂或有症状的 FRA；（b）入组前小脑 AVM 未出血；（c）FRA 采用母血管供血动脉 PAO 夹闭；（d）住院期间未对小脑 AVM 进行有创操作或通过其他供血动脉进行栓塞。
共纳入 8 例年龄 27-72 岁（48.6±14.3）岁的患者。8 例小脑 AVM 主要供血动脉近端破裂或有症状的 FRA 患者接受了线圈或 Onyx 栓塞母血管治疗，同时保留了动脉瘤远端的血管。8 例患者在随访 8-48 个月后均获得良好恢复。1 例患者 FRA 复发，行二次 PAO。
PAO 治疗小脑 AVM 主要供血动脉近端 FRA 是一种可行的选择。该方法在短期内可有效预防 FRA 再破裂和缓解症状，为患者后续治疗提供充足时间。
