Vinchon M, Laurian C, George B, D'arrigo G, Reizine D, Aymard A, Riché M C, Merland J J, Cormier J M
Service de Neurochirurgie, Hôpital Lariboisière, Paris, France.
Cardiovasc Surg. 1994 Jun;2(3):359-69.
The experience is reported with 50 vertebral fistulas treated by the authors in a joint radiological and surgical team. Of the 28 fistulas that were traumatic, 18 occurred after incidental iatrogenic puncture, and 22 were spontaneous, of which four presented in patients displaying angiographic features of fibromuscular dysplasia. Eleven patients were operated on and 33 had endovascular treatment. In nine patients who were either symptom-free or in poor health, no treatment was advised. The fistula was occluded in 38 (93%) of the treated patients, and the vertebral artery patency was preserved in 32 (78%). A total of 224 published cases were reviewed: 152 were traumatic, most after a penetrating injury; 72 were spontaneous, with three age peaks (at 7, 26 and 52 years). Treatment has evolved considerably and endovascular occlusion is now the treatment of choice, surgery being reserved for specific indications.
作者报告了一个由放射科和外科联合团队治疗50例椎体瘘的经验。在28例创伤性瘘中，18例发生于偶然的医源性穿刺后，22例为自发性瘘，其中4例患者表现出纤维肌发育异常的血管造影特征。11例患者接受了手术治疗，33例接受了血管内治疗。9例无症状或健康状况不佳的患者未建议进行治疗。在接受治疗的患者中，38例（93%）的瘘得以闭塞，32例（78%）的椎动脉保持通畅。对总共224例已发表病例进行了回顾：152例为创伤性，多数发生于穿透伤后；72例为自发性，有三个年龄高峰（7岁、26岁和52岁）。治疗方法有了很大进展，血管内闭塞现在是首选治疗方法，手术仅用于特定指征。
