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单家医疗机构手术治疗脑动静脉畸形的疗效:病例系列研究。

The efficacy of surgical treatment of cerebral arteriovenous malformations in a single academic institution: a case series.

机构信息

Kamil Duris, Faculty of Medicine, Masaryk University, 60177 Brno, Czech Republic,

出版信息

Croat Med J. 2021 Aug 31;62(4):353-359. doi: 10.3325/cmj.2021.62.353.

Abstract

AIM

To report on patients who underwent surgical treatment of arteriovenous malformations (AVMs) at our institution.

METHODS

This retrospective single-center case series enrolled the patients who underwent surgical treatment of pial AVM at the Department of Neurosurgery, University Hospital Brno, between 2005 and 2019. The data are summarized as descriptive statistics presenting basic characteristics in all the patients and in sex or age subgroups.

RESULTS

Fifty patients were enrolled. The majority of AVMs were of Spetzler-Martin grade II (n=27; 54%), localized supratentorialy (n=43; 86%), and half of AVMs were ruptured. A total resection was performed in 48 patients (96%), and a good overall outcome was achieved in 44 patients (88%). Surgery-associated morbidity was 2%, and the mortality rate was 0% due to meticulous selection of patients for surgical treatment.

CONCLUSION

Microsurgery is an appropriate method of treatment for S-M grade I-III pial AVMs. Microsurgery may be used to treat the majority of small-nidus AVMs with a low mortality and morbidity, when precisely planned and performed by an expert vascular team. The meticulous selection of patients for surgical treatment is crucial.

摘要

目的

报告在我们机构接受动静脉畸形(AVM)手术治疗的患者情况。

方法

这是一项回顾性单中心病例系列研究,纳入了 2005 年至 2019 年期间在布尔诺大学医院神经外科接受脑表面 AVM 手术治疗的患者。数据以描述性统计的形式汇总,呈现了所有患者以及按性别或年龄分组的基本特征。

结果

共纳入 50 名患者。大多数 AVM 为 Spetzler-Martin 分级 II 级(n=27;54%),局限于幕上(n=43;86%),一半的 AVM 为破裂型。48 名患者(96%)行完全切除,44 名患者(88%)获得良好的总体预后。手术相关发病率为 2%,死亡率为 0%,这是由于对手术治疗的患者进行了精心选择。

结论

对于 Spetzler-Martin 分级 I-III 级脑表面 AVM,显微手术是一种合适的治疗方法。当由经验丰富的血管团队精心规划和执行时,显微手术可用于治疗大多数小病灶 AVM,其死亡率和发病率较低。对手术治疗的患者进行精心选择至关重要。

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