摘要目的 探讨脑动静脉畸形的血管构筑特征与使用Onyx进行血管内栓塞治疗的技巧. 方法 选择自2005年3月至2006年12月广州医学院附属第二医院神经外科收治的26例脑动静脉畸形患者,根据脑血管造影和超选择造影后脑动静脉畸形的血管构筑特征,使用Onyx进行血管内栓塞治疗. 结果 脑动静脉畸形栓塞治疗前需分析房隔结构.引流静脉数量,引流是否通畅,供血方式及混合伴有动脉瘤或静脉结构等.粗大、危险性小的供血动脉及伴发动脉瘤的脑动静脉畸形应优先栓塞,对于多支供血的脑动静脉畸形需保护引流静脉.本组栓塞治疗后畸形血管团完全消失7例,消失90%以上10例,消失70%～90%的7例.消失70%以下2例. 结论 全面的脑血管造影可正确指导使用Onyx栓塞治疗脑动静脉畸形,掌握一定的推注技巧可以显著提高脑动静脉畸形血管内治疗的效果.

abstractsObjective To explore the vascular architecture features of cerebral arteriovenous malformations (AVMs) and discuss the application of Onyx for endovascular embolization. Methods Twenty-six patients with cerebral AVMs treated in our department from March 2005 to December 2006 were enrolled in this study. Based on the angioarchitecture features of the AVMs in the hindbrain identified by cerebral angiography and ultraselective angiography, Onyx was used to for endovascular embolizations of the AVMs. Results Prior to embolization of the AVMs with Onyx, the segmentation, number of the draining veins, presence of open drainage, feeding pattern and structures associated with aneurysms were analyzed. Priority of embolization was given to the AVMs complicated by aneurysms and the thick feeding arteries at low risk. In these patients, 7 (26.9%) showed completely resolved AVMs, 10 (38.5%) had vascular mass reduction by more than 90%, 7 (26.9%) had reduction by 70%-90%, and 2 (7.7%) had reduction by less than 70%. Conclusion A comprehensive cerebral angiography may help in effective embolization of the AVMs with Onyx, and the embolization effect can be enhanced with skillful injection techniques.