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首页> 外文期刊>Neurosurgery >Embolization of spinal cord arteriovenous shunts: morphological and clinical follow-up and results--review of 69 consecutive cases.
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Embolization of spinal cord arteriovenous shunts: morphological and clinical follow-up and results--review of 69 consecutive cases.

机译：脊髓动静脉分流栓塞术：形态学和临床随访及结果-连续69例病例的回顾。

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OBJECTIVE: We sought to analyze the results of embolization in patients with intradural spinal cord arteriovenous shunts. METHODS: The clinical and radiological files of 69 of a population of 155 patients treated with embolization between 1981 and 1999 were reviewed retrospectively. The patients' clinical status was evaluated according to Karnofsky Performance Scale score. Twenty-one (14%) of 155 patients were treated surgically because they were thought to be poor candidates for embolization. Twenty-four (15%) of 155 patients were considered untreatable with surgery or embolization; in these patients, follow-up was proposed, but only 8 of them were followed appropriately and remained stable after the first consultation. Forty-one (26%) of 155 patients consulted our group, but no follow-up could be obtained. In 69 (45%) of 155 patients, comprising 20 children and 49 adults, endovascular treatment was performed with the patients under general anesthesia and without provocative tests, mainly with acrylicglue, in 99% of these patients. RESULTS: The mean number of diagnostic and therapeutic sessions was 3.5 per patient, and the mean number of pure therapeutic sessions was 1.5 per patient. Follow-up ranged between 6 months and 18 years (mean, 5.6 yr). In 16% of patients, anatomic obliteration of spinal cord arteriovenous shunts was obtained. Embolization reduced more than 50% of the spinal cord arteriovenous shunts in 86% of cases. No recanalization was noted on follow-up angiograms. Good clinical outcomes were obtained in 83% of the patients: 15% of them were asymptomatic, 43% were improved, and 25% were stable. In 4% of patients, embolization failed to stabilize the disease. Transient deficits were seen after embolization in 14% of the patients, and permanent severe complications occurred in 4% of the patients (Karnofsky Performance Scale score
机译：目的：我们试图分析硬膜内脊髓动静脉分流患者的栓塞结果。方法：回顾性分析1981年至1999年间155例接受栓塞治疗的患者中69例的临床和影像学资料。根据卡诺夫斯基绩效量表评分评估患者的临床状况。 155名患者中有21名（14％）接受了手术治疗，因为他们被认为不适合栓塞治疗。 155名患者中有24名（15％）被认为无法手术或栓塞治疗;在这些患者中，建议进行随访，但是只有8例得到了适当的随访，并且在第一次咨询后保持稳定。 155例患者中有41例（26％）咨询过我们的小组，但未获得随访。在155名患者中的69名（45％）（包括20名儿童和49名成人）中，有99％的患者在全身麻醉且未进行刺激性检查的情况下进行了血管内治疗，主要是使用丙烯酸类药物，而没有进行刺激试验。结果：平均诊断和治疗时间为每位患者3.5次，平均纯治疗时间为每位患者1.5次。随访时间为6个月至18年（平均5.6年）。在16％的患者中，获得了脊髓动静脉分流的解剖学消除。在86％的病例中，栓塞减少了50％以上的脊髓动静脉分流。随访血管造影未发现再通。 83％的患者获得了良好的临床预后：其中15％无症状，43％改善，25％稳定。在4％的患者中，栓塞未能稳定疾病。 14％的患者栓塞后可见短暂性缺陷，4％的患者发生永久性严重并发症（Karnofsky Performance Scale得分<或= 70）。在9％的患者中观察到轻度恶化（Karnofsky Performance Scale score，80）。认为已完成血管内治疗后未见出血或再出血。结论：这项研究证明丙烯酸胶栓塞是一种治疗选择，与手术或其他药剂（颗粒，线圈或气球）栓塞相比具有优势。尽管不一定能完全治愈，但它可提供稳定的长期临床效果。为了证实这些令人鼓舞的治疗数据，有必要对较大系列的研究进行更长的随访。

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