[1]潘　力　刘　鹏　秦　杰　陈　剑　冯　雷　刘　军　杨　铭　马廉亭.儿童软脑膜动静脉瘘的血管内治疗（附3例报道及文献复习）[J].中国临床神经外科杂志,2017,(04):209-212.[doi:10.13798/j.issn.1009-153X.2017.04.001]
　PAN Li,LIU-Peng,QIN-Jie,et al.Endovascular treatment of pediatric pial arteriovenous fistulas: report of three cases and review of literature[J].,2017,(04):209-212.[doi:10.13798/j.issn.1009-153X.2017.04.001]
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儿童软脑膜动静脉瘘的血管内治疗（附3例报道及文献复 习）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年04期
页码:
209-212
栏目:
论著
出版日期:
2017-04-25

文章信息/Info

Title:
Endovascular treatment of pediatric pial arteriovenous fistulas: report of three cases and review of literature
文章编号:
1009-153X（2017）04-0209-04
作者:
潘　力　刘　鹏　秦　杰　陈　剑　冯　雷　刘　军　杨　铭　马廉亭
430070 武汉，中国人民解放军武汉总医院神经外科（潘　力、刘　鹏、秦　杰、陈　剑、杨　铭、马廉亭）；272011 山东，济宁市第一人民医院神经外科（冯　雷、刘　军）
Author(s):
PAN Li1;  LIU-Peng1;  QIN-Jie1;  CHEN Jian2;  FENG Lei2;  LIU Jun2;  YANG Ming1;  MA Lian-ting1.
1. Department of Neurosurgery, Wuhan General Hospital, PLA, Wuhan 430070, China;
2. Department of Neurosurgery, First People’s Hospital of Ji’ning City, Ji’ning 272011, China
关键词:
软脑膜动静脉瘘; 儿童; 血管内治疗; 疗效
Keywords:
Pial arteriovenous fistulas;  Children;  Endovascular therapy;  Curative effect
分类号:
R 743.4; R 815.2
DOI:
10.13798/j.issn.1009-153X.2017.04.001
文献标志码:
A
摘要:
目的 探讨儿童软脑膜动静脉瘘（PAVFs）的临床特点、诊断及血管内栓塞治疗的技术方法、安全性及疗效。方法 回顾性分析2013年7月至2015年7月血管内栓塞治疗的3例儿童PAVFs的临床资料。结果 3例均为单一瘘口，瘘口静脉端形成3~6 cm大小的静脉瘤。2例行瘘口及静脉瘤弹簧圈与18% ONYX胶栓塞，1例因静脉瘤太大通过双微导管技术仅行近瘘口供血动脉弹簧圈及18% ONYX胶栓塞。栓塞后即刻造影示3例瘘口均消失。术后症状缓解，无动脉栓塞、出血、神经功能缺失等并发症。经CTA或DSA随访6个月~2年均无复发。结论 单一瘘口的儿童PAVFs治愈率高，预后好。三维融合影像（3D-DSA双血管融合，CT/MRI及3D-DSA影像融合）有助于术前更好了解病变的血管解剖特点并制定手术方案；血管内栓塞治疗是理想的治疗方法，复发率低，但其有效性还需长期随访。
Abstract:
Objective To investigate the clinical characteristics, and diagnosis and treatment of pediatric pial arteriovenous fistulas (PAVFs). Methods The clinical data of 3 pediatric patients with PAVFs undergoing endovascular embolization from July, 2013 to July, 2015 were analyzed retrospectively. Results Of 3 patients with single orificium fistula associated with giant venous varices (3~6 cm), 2 underwent successful embolization of the fistulas and venous varices with coils and 18% ONYX, and 1 only embolization of the feeding artery and fistula by double microcatheters technique. DSA immediately after the embolization showed that the orificium fistulas completely disappeared in 3 patients. All the patients were followed up from 6 to 24 months. No complications including neurological deficits and so on occurred and no fistula recurred in 3 patients during the following-up. Conclusions The curative effects of endovascular embolization on the pediatric PAVFs are good. Three-dimensional fusion images are helpful to understanding of the characteristics and making of operative plan of the PAVFs in children.

参考文献/References:

[1] Upchurch K, Feng L, Duckwiler GR, et al. Nongalenic arteriovenous fistulas: history of treatment and technology [J]. Neurosurg Focus, 2006, 20: E8.
[2] Hetts SW, Keenan K, Fullerton HJ, et al. Pediatric intracra- nial nongalenic pial arteriovenous fistulas: clinical features, angioarchitecture, and outcomes [J]. Am J Neuroradiol, 2012, 33: 1710-1719.
[3] Ronald B, Wai SP, Michael SY, et al. Childhood posterior fossa pial-dural arteriovenous fistula treated by endovascu- lar occlusion [J]. Childs Nerv Syst, 2001, 17: 681-684.
[4] Zareen F, Keiichi I, Masaaki H, et al. Time-solved contrast- enhanced magnetic resonance digital subtraction angiogra- phy (MRDSA) in an infant with congenital pial arteriovenous fistula in the brain: a case report [J]. Childs Nerv Syst, 2010, 26: 1121-1124.
[5] Leopoldo G, Alfredo C, Teresa S, et al. Endovascular treat- ment of a pial arteriovenous fistula of a poeterior cerebellar artery with a double orgin [J]. J Neurointervent Surg, 2011, 3: 233-236.
[6] 蔡明俊，潘　力，马廉亭. 三维影像融合在软脑膜动静脉 瘘诊断与治疗中的应用价值[J]. 中国临床神经外科杂 志，2015，20：129-133.
[7] Daniele B, Elvis L, Raffaelino P, et al. Endovascular embo- lization of pial arteriovenous fistula fed from P1 segment of posterior cerebral artery in 12 years old girl case report and review of literature [J]. Neuroradiology, 2015, 28: 268-273.
[8] Matthew RS, Min SP, Cameron GM, et al. Endovascular approaches to pial arteriovenous malformations [J]. Neuro- surg Clin N Am, 2014, 25: 529-537.
[9] Gonzalez LF, Chaolouhi N, Jabbour P, et al. Rapid and progressive venous thrombosis after occlusion of high flow arteriovenous fistula [J]. World Neurosurg, 2013, 80: 359- 368.
[10] Srinivasan P, Naoki T, Yasunari N, et al. De novo develop- ment of dual arteriovenous fistula after endovascular embo- lization of pial arterioveous fistula [J]. J Neuro Intervent Surg, 2012, 10: 1136.

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更新日期/Last Update: 2017-04-25