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脑动静脉畸形患者快速心室起搏技术下的控制性低血压——病例报告

Controlled hypotension under rapid ventricular pacing technique in patients with cerebral arteriovenous malformation -a case report.

作者信息

Zhao Zijian, Wang Hang, Min Xinxu, Li Zheng, Feng Feng

机构信息

Department of Anesthesia and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Anesthesiology, Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao, China.

出版信息

Korean J Anesthesiol. 2025 Feb;78(1):79-84. doi: 10.4097/kja.24508. Epub 2024 Oct 28.

DOI:10.4097/kja.24508
PMID:39467537
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11834883/
Abstract

BACKGROUND

The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.

CASE

A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous AVM embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully.

CONCLUSIONS

RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

摘要

背景

经静脉途径治疗脑动静脉畸形（AVM）难度较大，需要严格控制血压和血流；然而，治愈率很高。适当的血压控制技术可使这些患者受益匪浅。

病例

一名55岁男性患者被发现患有动脉瘤并伴有脑AVM（长：2.0厘米，宽：1.6厘米，高：1.2厘米）。一期手术考虑进行动脉瘤栓塞，二期手术进行经静脉AVM栓塞。快速心室起搏（RVP）为手术提供了稳定的血流环境，手术顺利完成。

结论

因此，RVP可为经静脉途径栓塞脑AVM提供理想条件，且可作为一种可行的手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/cc8b2c60653e/kja-24508f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/b38a8a6e7bba/kja-24508f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/97525df34f2b/kja-24508f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/cc8b2c60653e/kja-24508f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/b38a8a6e7bba/kja-24508f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/97525df34f2b/kja-24508f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fa/11834883/cc8b2c60653e/kja-24508f3.jpg

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本文引用的文献

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Stroke. 2024 May;55(5):1449-1463. doi: 10.1161/STROKEAHA.124.046725. Epub 2024 Apr 22.
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Rapid ventricular overdrive pacing and other advanced flow-control techniques for the endovascular embolization of vein of galen malformations.用于大脑大静脉畸形血管内栓塞的快速心室超速起搏及其他先进的血流控制技术。
Front Pediatr. 2023 Mar 23;11:1082318. doi: 10.3389/fped.2023.1082318. eCollection 2023.
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Right ventricular pacing during TAVR: Make the things as simple as possible but not simpler.
经导管主动脉瓣置换术（TAVR）期间的右心室起搏：应将事情做到尽可能简单，但不要过于简单。
Int J Cardiol. 2023 Apr 15;377:42-43. doi: 10.1016/j.ijcard.2023.01.022. Epub 2023 Jan 20.
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Transvenous Embolization Technique for Brain Arteriovenous Malformations.经静脉栓塞术治疗脑动静脉畸形。
Neurosurg Clin N Am. 2022 Apr;33(2):185-191. doi: 10.1016/j.nec.2021.11.001. Epub 2022 Mar 2.
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Rapid Ventricular Pacing Facilitates Transarterial Embolization in Vein of Galen Malformations.快速心室起搏有助于静脉性 Galen 畸形的经动脉栓塞治疗。
Interv Neuroradiol. 2023 Apr;29(2):183-188. doi: 10.1177/15910199221082472. Epub 2022 Mar 2.
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