[1]刘建武　罗海涛　陈志华　赖贤良　宋书欣　毛国华　朱健明.岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧海绵窦区硬脑膜动静脉瘘[J].中国临床神经外科杂志,2019,(09):519-521.[doi:10.13798/j.issn.1009-153X.2019.09.003]
　LIU Jian-wu,LUO Hai-tao,CHEN Zhi-hua,et al.Transvenous embolization of bilateral cavernous sinus dural arteriovenous fistulas with Onyx and coils via inferior petrosal sinus approach[J].,2019,(09):519-521.[doi:10.13798/j.issn.1009-153X.2019.09.003]
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岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧海绵窦区硬脑膜动静脉瘘()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年09期
页码:
519-521
栏目:
论著
出版日期:
2019-09-20

文章信息/Info

Title:
Transvenous embolization of bilateral cavernous sinus dural arteriovenous fistulas with Onyx and coils via inferior petrosal sinus approach
文章编号:
1009-153X（2019）09-0519-03
作者:
刘建武　罗海涛　陈志华　赖贤良　宋书欣　毛国华　朱健明
330006 南昌，南昌大学第二附属医院神经外科（刘建武、罗海涛、陈志华、赖贤良、宋书欣、毛国华、朱健明）
Author(s):
LIU Jian-wu;  LUO Hai-tao;  CHEN Zhi-hua;  LAI Xain-liang;  SONG Shu-xin;  MAO Guo-hua;  ZHU Jain-ming
Department of Neurosurgery, Second Affiliated Hospital, Nanchang University, Nanchang 330006, China
关键词:
海绵窦区硬脑膜动静脉瘘; 血管内栓塞; 岩下窦入路; Onyx胶; 弹簧圈
Keywords:
Bilateral cavernous sinus;  Dural arteriovenous fistulas;  Inferior petrosal sinus;  Transvenous embolization;  clinical effect;  Complications
分类号:
R 743.4; R 815.2
DOI:
10.13798/j.issn.1009-153X.2019.09.003
文献标志码:
A
摘要:
目的 探讨岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧海绵窦区硬脑膜动静脉瘘（CSDAVF）的安全性和有效性。方法 回顾性分析2013年9月至2018年9月经岩下窦入路Onyx胶联合弹簧圈栓塞治疗的7例双侧CSDAVF的临床资料。结果 7例14侧CSDAVF中，完全栓塞13侧，次全栓塞1侧。术后动眼神经麻痹加重1例，外展神经麻痹加重1例。术后随访6个月，14侧瘘口均未显影，1例动眼神经麻痹基本恢复，1例外展神经麻痹部分恢复。结论 经岩下窦入路Onyx胶联合弹簧圈栓塞治疗双侧CSDAVF疗效确切，并发症较单侧更常见；有效使用弹簧圈及Onyx胶对手术成功及减少并发症至关重要。
Abstract:
Objective To investigate the safety and outcomes of transvenous embolization of bilateral cavernous sinus dural arteriovenous fistulas (CSDAVF) with Onyx and coils. Method The clinical and follow-up data of 7 patients with bilateral CSDAVF who accepted transvenous embolization with onyx and coils via inferior petrosal sinus approach from September, 2013 to September, 2018 were analyzed retrospectively. Results Of 14 CSDAVF in 7 patients with bilateral CSDAVF, 13 were totally embolized and 1 subtotally. One patient had aggravation of oculomotor paralysis and 1 patient had aggravation of abducent paralysis after the embolization. The following-up 6 months after the embolization showed that CSDAVF did not recurred in all the patients. The patient was basically recovered from oculomotor paralysis, and the another patient was slightly recovered from abducent paralysis. Conclusions The clinical effect of transvenous embolization of CSDAVF with Onyx and coils via inferior petrosal sinus approach is good, but the complications are more common after the embolization in the patients with bilateral CSDAVF than those in the patients with unilateral CSDAVF. The practised skill of endovascular emboliation is very important to successful treatment of CSDAVF and reducing complications.

参考文献/References:

[1] Rhim JK, Cho YD, Yoo DH, et al. Endovascular treatment of bilateral cavernous sinus dural arteriovenous fistula: therapeutic strategy and follow-up outcomes [J]. Korean J Radiol, 2018, 19(2): 334-341.[2] van Dijk JMC, TerBrugge KG, Willinsky RA, et al. Multipli-city of dural arteriovenous fistulas [J]. J Neurosurg, 2002, 96: 76-78.[3] Hacein-Bey L, Konstas AA, Pile-Spellman J, et al. Natural history, current concepts, classification, factors impacting endovascular therapy, and pathophysiology of cerebral and spinal dural arteriovenous fistulas [J]. Clin Neurol Neuro-surg, 2014, 121: 64-75.[4] Kiyosue H, Hori Y, Okahara M, et al. Treatment of intracra-nial dural arteriovenous fistulas: Current strategies based onlocation and hemodynamics, and alternative techniques of transcatheter embolization [J]. Radiographics, 2004, 24(6): 1637-1653.[5] Miller TR, Gandhi D. Intracranial dural arteriovenous fistu-lae clinical presentation and management strategies [J]. Stroke, 2015, 46(7): 2017-2025.[6] 张伟国，叶莹莹，谭立文，等. 岩下窦薄层断面相关解剖与三维重建及其临床意义[J]. 中国临床解剖学杂志，2009，27（2）：137-140.[7] 叶莹莹，张海鹰，马富英. 岩下窦的影像解剖学研究及临床意义研究进展[J]. 中西医结合心脑血管病杂志，2015，13（16）：1853-1856.[8] Mortazavi MM, Griessenauer CJ, Krishnamurthy S, et al. The inferior petrosal sinus: a comprehensive review with emphasis on clinical implications [J]. Child Nerv Syst, 2014, 30(5): 831-834.[9] Jung KH, Kwon BJ, Chu K, et al. Clinical and angiographic factors related to the prognosis of cavernous sinus dural arteriovenous fistula [J]. Neuroradiology, 2011, 53: 983-992.[10] Nishino K, Ito Y, Haseqawa H, et al. Cranial nerve palsy following transvenous embolization for a cavernous sinus dural arteriovenous fistula: association with the volume and location of detachable coils [J]. J Neurosurg, 2008, 109: 208-214.

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备注/Memo

备注/Memo:
通讯作者：朱健明，E-mail：544502643@qq.com（2019-02-27收稿，2019-05-01修回）
更新日期/Last Update: 2019-09-20