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纸质出版:2009
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陈志,唐卫华,缪洪平,储卫华,崔高宇,冯华,朱刚.海绵窦区硬脑膜动静脉瘘的治疗探讨[J].陆军军医大学学报(原第三军医大学学报),2009,31(13):1309-1311.
CHEN Zhi,TANG Wei-hua,MIAO Hong-ping,CHU Wei-hua,CUI Gao-yu,FENG Hua,ZHU Gang.Treatment of cavernous sinus dural arteriovenous fistula[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(13):1309-1311.
目的 探讨海绵窦区硬脑膜动静脉瘘(dural arteriovenous fistula
DAVF)的治疗方法、效果及预后。 方法 25例患者中8例行颈动脉压迫或仅随访观察;17例行血管内栓塞,其中3例经静脉途径栓塞,13例经动脉途径栓塞,其中1例联合使用覆膜支架和Glubran胶治疗,1例经动脉途径治疗后再次接受经静脉途径栓塞治疗。 结果 8例行颈动脉压迫或随访观察的患者中有4例症状缓解或消失,其余患者无加重;3例经静脉途径栓塞者均通过同侧或对侧岩下窦入路完全闭塞瘘口;13例经动脉途径栓塞者中4例完全闭塞瘘口,其余患者症状部分缓解;1例患者首次经动脉途径部分栓塞术后症状加重,急诊经眼上静脉穿刺置管完全栓塞。 结论 海绵窦区DAVF总体预后良好,可根据患者症状和影像学特征选择恰当的治疗方式
经静脉途径栓塞治愈率高,适宜者应作为首选治疗方法。
Objective To investigate the therapeutic methods
efficacy
and prognosis for cavernous sinus dural arteriovenous fistula (DAVF). Methods A total of 25 patients underwent DSA and were treated by compression of common carotid artery or just follow-up (8 cases)
transarterial embolization (13 cases)
transvenous embolization (3 cases)
respectively. Transvenous embolization was carried out in 1 case after palliative transarterial embolization. Results Clinical cure or alleviation was achieved in 4 out of 8 cases treated by compression of common carotid artery or follow-up only. Immediate complete obliteration of the fistula was achieved in 4 out of 13 cases treated by transarterial embolization. Worsening of ocular symptoms was observed in 1 case following palliative transarterial embolization
and complete occlusion of the fistula was achieved by urgent transvenous embolization. Immediate complete obliteration of the fistula was achieved in all the cases treated by transvenous embolization. Conclusion Most cavernous sinus DAVFs are benign and stable. Familiarity with the drainage patterns is essential for the treatment strategies. Transvenous embolization may be the first choice for the treatment of cavernous sinus DAVFs.
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