Debrun G, Vinuela F, Fox A, Drake C G
J Neurosurg. 1982 May;56(5):615-27. doi: 10.3171/jns.1982.56.5.0615.
Forty-six patients with cerebral arteriovenous malformations (AVM's) were selected for embolization with bucrylate. These patients were assigned to three different groups. Group I consisted of 22 patients with nonresectable AVM's who were selected for embolization with a Silastic calibrated-leak ballon. In 16 or these patients, embolization was achieved, with partial obliteration of the AVM in 14 and complete obliteration in two. Five patients had subarachnoid hemorrhage caused by the balloon bursting and concomitant dissection of the feeding vessel. Four of these patients recovered completely and one died of a brain-stem hemorrhage. A permanent field defect was noted in five cases, and two patients had a transient mild neurological deficit. Group II consisted of 13 patients treated by intraoperative embolization. Complete obliteration by embolization was obtained in four cases, and complete surgical resection after embolization in five. Partial embolization with no surgical resection was achieved in five cases. Three of these patients had a permanent mild neurological deficit and two had transient deficits. There was no mortality in this group. Group III consisted of 11 patients treated by embolization with bucrylate using a new latex calibrated-leak balloon. This balloon has a higher malleability, and takes on the exact configuration of the feeder, with no risk of dissection. This balloon also permits delivery of the faster and larger injection of bucrylate to the arterial feeders of the AVM. Two AVM's were completely obliterated, and embolization was only partially successful in the other cases. Neurological complications consisted of incomplete field defects in two cases, slight memory loss in one case, and transient clumsiness of the arm and face in one case. Two patients have a catheter permanently glued in the malformation, with no neurological complication. There was no mortality in this group.
46例脑动静脉畸形（AVM）患者被选入用丁氰酯进行栓塞治疗。这些患者被分为三组。第一组由22例不可切除的AVM患者组成，他们被选入用硅橡胶校准漏气球囊进行栓塞治疗。在这些患者中的16例实现了栓塞，其中14例AVM部分闭塞，2例完全闭塞。5例患者因球囊破裂及伴随的供血血管剥离导致蛛网膜下腔出血。这些患者中的4例完全康复，1例死于脑干出血。5例出现永久性视野缺损，2例有短暂性轻度神经功能缺损。第二组由13例术中栓塞治疗的患者组成。4例通过栓塞实现完全闭塞，5例在栓塞后进行了完全手术切除。5例实现了部分栓塞但未进行手术切除。这些患者中的3例有永久性轻度神经功能缺损，2例有短暂性缺损。该组无死亡病例。第三组由11例用新型乳胶校准漏气球囊用丁氰酯进行栓塞治疗的患者组成。这种球囊具有更高的柔韧性，能与供血血管的精确形态相贴合，无剥离风险。这种球囊还允许向AVM的动脉供血血管更快、更大剂量地注入丁氰酯。2例AVM完全闭塞，其他病例栓塞仅部分成功。神经并发症包括2例不完全视野缺损、1例轻微记忆力丧失、1例手臂和面部短暂笨拙。2例患者的导管永久粘在畸形部位，无神经并发症。该组无死亡病例。
