摘要目的:初步探讨近端血管阻断技术在经静脉入路栓塞颅内动静脉畸形(AVM)中的应用。方法:回顾性分析2016年3月至2021年3月哈尔滨医科大学附属第一医院神经外科采用近端血管阻断技术经静脉入路栓塞治疗的4例颅内AVM患者的临床资料。术后7 d内复查头颅CT或MRI，判断出血或缺血性并发症情况。术后1、3、6、12个月行门诊随访，并应用改良Rankin量表评分(mRS)评估患者的预后情况，其中0~2分为预后良好，>2分为预后不良。结果:4例患者均手术成功，术后即刻数字减影血管造影(DSA)显示3例完全治愈，另1例AVM的栓塞面积≥90%。术后1例患者因脑室出血发生脑疝死亡，其余3例术后均无并发症。3例患者均获得随访，随访时间[ M(范围)]为13个月(8~16个月)。至末次随访，3例患者均预后良好，其中2例患者mRS为1分，另1例为0分。 结论:初步发现应用近端血管阻断技术经静脉入路栓塞颅内AVM的疗效较好，术后并发症较少，但仍需进一步研究确认。

abstractsObjective:To explore the application of pressure cooker technique (PCT) in transvenous embolization of intracranial arteriovenous malformations (AVM).Methods:The clinical data of 4 patients with intracranial AVM who underwent transvenous embolization by PCT in the Department of Neurosurgery of the First Affiliated Hospital of Harbin Medical University from March 2016 to March 2021 were retrospectively analyzed. Cranial CT or MRI was reviewed within 7 days after operation to determine the bleeding or ischemic complications. Outpatient follow-up was performed at 1, 3, 6, and 12 months after operation, and the outcome of the patients was evaluated by the modified Rankin scale (mRS), in which 0-2 indicated good outcome, and >2 indicated poor outcome.Results:All 4 patients underwent successful operations. Immediate postoperative DSA showed that 3 patients were completely cured, and the other 1 patient had an embolization area of ≥90% AVM. One patient died of cerebral herniation due to intraventricular hemorrhage after operation, and the remaining 3 patients had no postoperative complications. Three patients were followed up, and the follow-up time [ M (range)] was 13 (8-16) months. At the last follow-up, all 3 patients had good outcomes. The mRS score of 1 was reported in 2 patients and that of 0 was reported in 1. Conclusion:Preliminary findings show that PCT is effective in embolizing intracranial AVM via transvenous approach, with fewer postoperative complications, but further research and verification are needed.