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首页> 外文期刊>Acta Neurochirurgica >Critical appraisal of endovascular treatment of brain arteriovenous malformation using Onyx in a series of 92 consecutive patients
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Critical appraisal of endovascular treatment of brain arteriovenous malformation using Onyx in a series of 92 consecutive patients

机译：连续92例患者使用Onyx进行血管内治疗脑动静脉畸形的关键评估

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Background: The introduction of Onyx has led us to adopt a new treatment approach for brain arteriovenous malformation (AVM), using endovascular embolization with Onyx as the first line treatment with a curative intent. The aim of the present report is to evaluate our results using this strategy, with special emphasis on angiographic characteristics affecting treatment risks and success rates. Methods: From October 2006 to December 2009, 92 consecutive patients harboring brain AVM were treated with Onyx during 177 procedures. Results: Endovascular treatments were completed in 68 out of 92 patients. Median number of procedures was two. Complete obliteration using embolization exclusively was achieved in 25 patients, resulting in a 37 % cure rate in patients who concluded treatments (25/68), and 27 % in the cohort. In Spetzler-Martin grades 1 & 2 AVMs, complete obliteration was achieved in 48 % of the cases. Complete obliteration rates were significantly higher in lesions with superficial big feeding arteries. There were 15 bleeding complications during 177 embolization sessions (8.4 % per procedure); seven cases resolved in less than 3 months. Permanent disability rate was 6.5 %; mortality rate was 2.2 %. Bleeding was related to the use of the microcatheter/guidewire in six cases and to the use of the embolization material in nine, the amount of Onyx injected was significantly higher in those nine cases. Conclusions: Embolization of brain AVM using Onyx and detachable tip microcatheters results in a relatively high rate of complete obliteration. Angioarchitecture of the lesion can predict treatment success. Higher amounts of Onyx injected per session increase the bleeding risk.
机译：背景：Onyx的引入使我们采用了一种针对脑动静脉畸形（AVM）的新治疗方法，该方法采用血管内栓塞与Onyx作为具有治愈意图的一线治疗。本报告的目的是使用这种策略评估我们的结果，特别强调影响治疗风险和成功率的血管造影特征。方法：自2006年10月至2009年12月，在177例手术中，连续对92例脑部AVM患者进行了Onyx治疗。结果：92例患者中有68例完成了血管内治疗。中位数为两个。仅25例患者使用栓塞术完全闭塞，治愈率（25/68）的患者治愈率为37％，同期队列的患者为27％。在Spetzler-Martin 1级和2级AVM中，有48％的病例完全闭塞。浅表大供血动脉病变的完全闭塞率明显更高。 177例栓塞治疗期间有15例出血并发症（每次手术的8.4％）;在不到3个月的时间内解决了7例病例。永久残废率为6.5％;死亡率是2.2％。 6例出血与微导管/导丝的使用有关，9例出血与栓塞材料的使用有关，在这9例中，Onyx的注射量明显更高。结论：使用Onyx和可拆卸的尖端微导管栓塞脑AVM导致完全闭塞的发生率相对较高。病变的血管结构可以预测治疗成功。每个疗程注射更多量的On玛瑙会增加出血风险。

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