Deng Xianming, Dong Mengqi, Peng Chao, Ding Xiaowen, Wang Kun, Qin Kun, Chen Guangzhong
Department of Neurosurgery, Guangdong General Hospital, Institute of Neuroscience, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
Southern Medical University, Guangzhou, Guangdong Province, China.
J Interv Med. 2019 Apr 30;1(3):164-169. doi: 10.19779/j.cnki.2096-3602.2018.03.06. eCollection 2018 Aug.
The aim of this study is to evaluate the embolization techniques, as well as the effects and complications, using the non-adhesive liquid embolic material Onyx in intracranial arteriovenous malformations (AVMs). The study comprises a retrospective analysis of 250 patients with intracranial AVMs treated with Onyx in Guangdong General Hospital from Jan 2010 to Dec 2017. The therapeutic strategies, as well as embolization effects and complications, of Onyx are summarized. Of 250 cases, 170 were male and 80 were female. Following the Spetzler-Martin (S-M) grading system, there were 35 cases of grade I, 77 of grade II, 72 of grade III, 39 of grade IV, and 27 of grade V. All cases were treated with Onyx. In addition, 69 cases were treated with Glubran glue. The injected volume of Onyx per patient ranged from 1 mL to 10 mL. The largest volume of Onyx injected in one procedure was 10 mL. The cure rate was 67.9% (76/112) of grade I-II patients, 15.0% (11/72) of grade III patients, 7.7% (3/39) of grade IV patients, and 0% (0/27) of grade V patients. The total cure rate was 36.0% (90/250). The average number of targeted vascular branches per patient was 2.28. The microcatheter broke off in two cases. There were two patients who suffered an intracranial hemorrhage during the embolic procedure; in one of these two patients, the microcatheter also broke off. There were two patients who suffered an intracranial hemorrhage after the embolic procedure; one of them died. Seven cases suffered new-onset neurological deficits or their original symptoms deteriorated. Six of them improved or recovered within 3-6 months. The total complication rate was 5.2% (13/250). The application of Onyx in intracranial AVMs is flexible, effective and safe, and may also reduce the complications.
本研究旨在评估使用非粘性液体栓塞材料Onyx治疗颅内动静脉畸形（AVM）的栓塞技术以及疗效和并发症。该研究对2010年1月至2017年12月在广东省人民医院接受Onyx治疗的250例颅内AVM患者进行了回顾性分析。总结了Onyx的治疗策略以及栓塞效果和并发症。250例患者中，男性170例，女性80例。按照斯佩茨勒-马丁（S-M）分级系统，Ⅰ级35例，Ⅱ级77例，Ⅲ级72例，Ⅳ级39例，Ⅴ级27例。所有病例均采用Onyx治疗。此外，69例采用了Glubran胶水治疗。每位患者Onyx的注射量为1毫升至10毫升。单次手术中Onyx的最大注射量为10毫升。Ⅰ-Ⅱ级患者的治愈率为67.9%（76/112），Ⅲ级患者为15.0%（11/72），Ⅳ级患者为7.7%（3/39），Ⅴ级患者为0%（0/27）。总治愈率为36.0%（90/250）。每位患者的目标血管分支平均数量为2.28个。有2例微导管断裂。有2例患者在栓塞过程中发生颅内出血；其中1例微导管也断裂。有2例患者在栓塞术后发生颅内出血；其中1例死亡。7例出现新发神经功能缺损或原有症状加重。其中6例在3至6个月内好转或恢复。总并发症发生率为5.2%（13/250）。Onyx在颅内AVM中的应用灵活、有效且安全，还可能减少并发症。
