Marks M P, Lane B, Steinberg G K, Fabrikant J I, Levy R P, Frankel K A, Phillips M H
Department of Diagnostic Radiology, Stanford University School of Medicine, CA.
AJNR Am J Neuroradiol. 1993 Mar-Apr;14(2):297-303; discussion 304-5.
Previous reports of embolization of cerebral arteriovenous malformations (AVMs) have evaluated the technique as adjunctive therapy prior to surgery or radiosurgery; our aim is to assess the role of embolization following radiosurgery.
Six patients previously treated with radiosurgery and showing no response as judged by cerebral angiography were embolized 24 to 55 months (mean 34.3 months) after initial radiosurgery.
In five of six, a significant volume reduction was achieved ranging from 60%-100% (mean 74%). One patient was treated with embolization alone and the AVM has remained fully thrombosed 2 years after treatment. Three patients underwent surgical resection for cure after embolization, and two patients had repeat radiosurgery to a significantly smaller AVM volume. One patient had an asymptomatic carotid dissection at embolization; however, no clinically apparent complications occurred in the treatment group.
Embolization can be used after radiosurgery to assist in the management of those AVMs that have not responded to initial treatment.
先前关于脑动静脉畸形（AVM）栓塞治疗的报告将该技术评估为手术或放射外科手术前的辅助治疗；我们的目的是评估放射外科手术后栓塞治疗的作用。
6例先前接受过放射外科手术且经脑血管造影判断无反应的患者，在首次放射外科手术后24至55个月（平均34.3个月）接受了栓塞治疗。
6例中的5例实现了显著的体积缩小，范围为60% - 100%（平均74%）。1例患者仅接受了栓塞治疗，治疗后2年AVM仍完全血栓形成。3例患者在栓塞后接受了手术切除以治愈，2例患者对明显缩小的AVM体积进行了再次放射外科手术。1例患者在栓塞时发生了无症状的颈动脉夹层；然而，治疗组未出现明显的临床并发症。
放射外科手术后可使用栓塞治疗来辅助管理那些对初始治疗无反应的AVM。
