Spetzler R F, Martin N A, Carter L P, Flom R A, Raudzens P A, Wilkinson E
J Neurosurg. 1987 Jul;67(1):17-28. doi: 10.3171/jns.1987.67.1.0017.
A series of 20 patients with giant arteriovenous malformations (AVM's) managed with staged embolization and surgical resection is presented. Complete excision was accomplished in 18 of these patients. There were no deaths and only three complications, of which one was disabling. Further evidence for the presence of low perfusion surrounding the AVM, emphasizing the risk of normal perfusion pressure breakthrough, is provided by cortical perfusion pressure, cortical cerebral blood flow (CBF), and stable xenon computerized tomography CBF measurements. The staged approach to giant AVM management is a proposed method to render AVM's that were previously considered inoperable or marginally operable into totally excisable lesions, while maintaining an acceptable level of morbidity and mortality.
本文报告了一组20例患有巨大动静脉畸形（AVM）的患者，他们接受了分期栓塞和手术切除治疗。其中18例患者实现了完全切除。无死亡病例，仅出现3例并发症，其中1例导致残疾。皮质灌注压、皮质脑血流量（CBF）以及稳定的氙计算机断层扫描CBF测量结果，进一步证明了AVM周围存在低灌注，强调了正常灌注压突破的风险。对于巨大AVM的分期治疗方法，是一种旨在将先前被认为无法手术或勉强可手术的AVM转变为可完全切除的病变的方法，同时保持可接受的发病率和死亡率水平。
