Nakahara I, Taki W, Kikuchi H, Sakai N, Isaka F, Oowaki H, Kondo A, Iwasaki K, Nishi S
Department of Neurosurgery, Faculty of Medicine, Kyoto University, Japan.
Neuroradiology. 1999 Jan;41(1):60-6. doi: 10.1007/s002340050707.
The association between intracranial aneurysms and arteriovenous malformations (AVMs) is well documented. Recent advances in the understanding of the haemodynamics of this association encourage an aggressive approach to these aneurysms. However, the pathophysiology of these aneurysms is not fully understood and a strategy for their management has not been established. We describe seven patients, with eight aneurysms, on the feeding arteries of AVMs. The aneurysms could be divided into those located 1. proximally on the superficial feeding artery (type I; 4 aneurysms); 2. distally on the superficial feeding artery (type II; 3 aneurysms); and 3. on the deep feeding artery (type III; 1 aneurysm). All aneurysms were treated by the endovascular procedure prior to, or simultaneously with, treatment of the AVM, using detachable coils or liquid embolic material. All aneurysms were obliterated successfully, with no adverse events. Each patient further received treatment of the AVM. None of the patients suffered intracranial haemorrhage after treatment for the aneurysms. Based on our experiences, we discuss the indications for this approach for each type of aneurysm. We believe endovascular treatment could be an important alternative for treatment of aneurysms associated with AVMs, thus reducing the risk of haemorrhage.
颅内动脉瘤与动静脉畸形（AVM）之间的关联已有充分记载。对这种关联的血流动力学理解方面的最新进展促使对这些动脉瘤采取积极的治疗方法。然而，这些动脉瘤的病理生理学尚未完全明确，其治疗策略也尚未确立。我们描述了7例患者，其AVM的供血动脉上有8个动脉瘤。这些动脉瘤可分为：1. 位于浅表供血动脉近端的（I型；4个动脉瘤）；2. 位于浅表供血动脉远端的（II型；3个动脉瘤）；3. 位于深部供血动脉的（III型；1个动脉瘤）。所有动脉瘤均在治疗AVM之前或同时采用可脱卸弹簧圈或液体栓塞材料通过血管内介入手术进行治疗。所有动脉瘤均成功闭塞，未发生不良事件。每位患者随后均接受了AVM治疗。治疗动脉瘤后，无一例患者发生颅内出血。基于我们的经验，我们讨论了针对每种类型动脉瘤采用这种治疗方法的适应证。我们认为血管内治疗可能是治疗与AVM相关动脉瘤的一种重要替代方法，从而降低出血风险。
