儿童软脑膜动静脉瘘的血管内治疗（附3例报道和文献复习）.PDFVIP

中国临床神经外科杂志2017 年4 月第22 卷第4 期 Chin J Clin Neurosurg, April 2017, Vol. 22, No. 4 - 209 - ● 论论 著著 ● 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） 潘 力 刘 鹏 秦 杰 陈 剑 冯 雷 刘 军 杨 铭 马廉亭 【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。 【关键词】软脑膜动静脉瘘；儿童；血管内治疗；疗效 【文章编号】1009-153X（2017 ）04-0209-04 【文献标志码】A 【中国图书资料分类号】R 743.4; R 815.2 Endovasculartreatmentofpediatricpialarteriovenousfistulas:reportofthreecasesandreviewofliterature 1 1 1 2 2 2 1 1 PANLi,LIU-Peng,QIN-Jie,CHENJian,FENGLei,LIUJun,YANGMing,MALian-ting.1.DepartmentofNeurosurgery, WuhanGeneralHospital,PLA,Wuhan430070,China;2.Department of Neurosurgery, First Peoples Hospital of Jining City, Jining 272011,China 【Abstract】Objective To investigate the clinical characteristics, and diagnosis and treatment of pediatric pial arteriovenous fistulas (PAVFs). MethodsThe clinical data of 3 pediatric patients with PAVFs undergoing endovascular embolization from July, 2013 to July, 2015 were analyzed retrospectively. ResultsOf 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