Chen Xiheng, Zhang Longhui, Zhu Haoyu, Wang Yajie, Fan Liwei, Ni Leying, Dong Linggen, Lv Ming, Liu Peng
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
Front Neurol. 2022 Aug 22;13:813207. doi: 10.3389/fneur.2022.813207. eCollection 2022.
Transvenous embolization (TVE) has been proven to be safe and feasible as an alternative management of brain arteriovenous malformations (AVMs). We presented four patients with a hemorrhagic brain AVM who underwent TVE and reviewed the relevant literature.
Four patients underwent TVE of a hemorrhagic brain AVM in our center between July 2019 and July 2020. We retrospectively collected and analyzed the clinical and imaging data of these patients and those reported in previously published studies.
Four patients with a hemorrhagic brain AVM were included. Nidus sizes ranged from 0.79 to 2.56 cm. Spetzler-Martin grade ranged from grade II to grade III. The AVM nidus was located in a deep brain region in three patients. One patient underwent TVE alone and three underwent combined transarterial and transvenous approaches. Digital subtraction angiography (DSA) demonstrated complete obliteration of the vascular malformation after embolization in all four patients. Three patients were independent [modified Rankin Scale (mRS) score ≤ 2] at discharge. All four patients were independent at the last follow-up. AVM obliteration was confirmed in all four patients at the last angiographic follow-up.
Transvenous embolization can be used as an alternative treatment for contemporary management of brain AVMs, appropriate patient selection is essential to achieve a good clinical outcome.
经静脉栓塞术（TVE）已被证明作为脑动静脉畸形（AVM）的一种替代治疗方法是安全可行的。我们报告了4例接受TVE治疗的出血性脑AVM患者，并回顾了相关文献。
2019年7月至2020年7月期间，4例患者在我们中心接受了出血性脑AVM的TVE治疗。我们回顾性收集并分析了这些患者以及先前发表研究中报道的患者的临床和影像数据。
纳入4例出血性脑AVM患者。病灶大小为0.79至2.56 cm。Spetzler-Martin分级为Ⅱ级至Ⅲ级。3例患者的AVM病灶位于脑深部区域。1例患者仅接受了TVE治疗，3例患者接受了经动脉和经静脉联合治疗。数字减影血管造影（DSA）显示所有4例患者栓塞后血管畸形完全闭塞。3例患者出院时独立（改良Rankin量表[mRS]评分≤2）。所有4例患者在最后一次随访时均独立。在最后一次血管造影随访中，所有4例患者均证实AVM闭塞。
经静脉栓塞术可作为当代脑AVM治疗的替代方法，选择合适的患者对于取得良好的临床效果至关重要。
