Debrun G M, Aletich V, Ausman J I, Charbel F, Dujovny M
Department of Radiology and Neurosurgery, University of Illinois at Chicago, USA.
Neurosurgery. 1997 Jan;40(1):112-20; discussion 120-1.
To demonstrate that nidus embolization of brain arteriovenous malformations (AVMs) with Histoacryl (B. Braun, Melsungen, Germany) is effective and yields low morbidity and mortality rates.
We present a retrospective analysis of 54 brain AVMs treated at the University of Illinois at Chicago from April 1994 to December 1995. Treatment modalities included embolization in all cases and then surgical resection or radiosurgery.
The nidus was reached with the combined use of a Magic microcatheter (Balt, Montmorency, France) and a Terumo 0.010-inch guidewire.
Embolization was performed only when the tip of the microcatheter was wedged into the nidus of the AVMs with no reflux of contrast proximally. The embolization was performed using simultaneous biplane roadmapping with the patient under general anesthesia without Amytal testing.
Twenty-six of 54 patients are still waiting for more radical treatment. Two deaths and two minor and one severe permanent neurological deficit occurred. Three patients were cured with embolization alone; 11 patients were cured after surgical resection. Three patients underwent radiosurgery, with one cure after 1 year.
Nidus embolization with Histoacryl is an effective technique that permits complete cure of a large number of brain AVMs, with or without surgical resection and/or radiosurgery.
证明使用 Histoacryl（德国梅尔松根市贝朗公司）对脑动静脉畸形（AVM）进行瘤巢栓塞是有效的，且发病率和死亡率较低。
我们对1994年4月至1995年12月在伊利诺伊大学芝加哥分校接受治疗的54例脑AVM进行了回顾性分析。治疗方式包括所有病例均先行栓塞，然后进行手术切除或放射外科治疗。
联合使用Magic微导管（法国蒙特莫朗西市巴尔公司）和泰尔茂0.010英寸导丝到达瘤巢。
仅在微导管尖端楔入AVM瘤巢且近端无造影剂反流时进行栓塞。栓塞在全身麻醉下使用双平面同步路径图技术进行，无需阿米妥试验。
54例患者中有26例仍在等待更彻底的治疗。发生了2例死亡、2例轻度和1例重度永久性神经功能缺损。3例患者仅通过栓塞治愈；11例患者在手术切除后治愈。3例患者接受了放射外科治疗，其中1例在1年后治愈。
使用Histoacryl进行瘤巢栓塞是一种有效的技术，无论是否联合手术切除和/或放射外科治疗，都能使大量脑AVM得到完全治愈。
