Hybrid Operating Room for the Treatment of Spetzler-Martin Grade III-V Brain Arteriovenous Malformation: An Institutional Experience.

Jiao Cheng, Bingwei Song, Liang He, Ke Yan, Linhai Shen, Kai Hu, Yong Zhen
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Abstract

Aim: To report our institutional experience of the one-stop treatment of Spetzler-Martin grade (SMG) III-V brain arteriovenous malformations (BAVMs) in a hybrid operating room.

Material and methods: Clinical data obtained from all the patients with SMG III-V BAVMs who underwent one-stop treatment in a hybrid operating room were analyzed. The measures included imaging characteristics, intraoperative blood loss, postoperative complications, residual lesions, and the presence of postoperative recurrence. Outcomes were assessed using the Glasgow outcome scale (GOS) score at six months post-surgery.

Results: A total of 16 patients were included in this study, 7 of whom underwent endovascular embolization followed by microsurgical resection and 9 underwent intraoperative cerebral angiography-assisted microsurgery. The average intraoperative blood loss was 473.3 mL. A remnant of BAVMs was found on the intraoperative cerebral angiography of one patient. Two patients underwent decompressive craniectomy due to postoperative cerebral swelling, including one patient with occipital lobe cerebral infarction and aphasia. No mortality was recorded. At the six-month postoperative follow-up visit, the GOS scores were 3 (n=4, 25.0%), 4 (n=4, 25.0%), and 5 (n=8, 50.0%). No recurrence was noted on brain digital subtraction angiography (DSA) in any of the postoperative reexaminations.

Conclusion: A hybrid operating room can fully combine the advantages of microsurgery and endovascular interventions, allowing for a high resection rate in the surgical treatment of SMG III-V BAVMs and a low rate of postoperative complications.

混合手术室治疗 Spetzler-Martin III-V 级脑动静脉畸形:机构经验。
目的:本研究旨在报告我院在混合手术室一站式治疗Spetzler-Martin III-V级(SMG)脑动静脉畸形(BAVM)的经验:分析了所有在混合手术室接受一站式治疗的SMG III-V级脑动静脉畸形患者的临床数据。测量指标包括成像特征、术中失血量、术后并发症、残留病灶以及术后复发情况。结果采用术后6个月的格拉斯哥结果量表(GOS)评分进行评估:本研究共纳入了16名患者,其中7人接受了血管内栓塞术,然后进行了显微手术切除,9人接受了术中脑血管造影辅助显微手术。术中平均失血量为 473.3 毫升。一名患者在术中脑血管造影中发现了 BAVMs 残留。两名患者因术后脑肿胀而接受了减压开颅手术,其中一名患者伴有枕叶脑梗塞和失语。无死亡记录。术后6个月随访时,GOS评分分别为3分(4人,25.0%)、4分(4人,25.0%)和5分(8人,50.0%)。术后复查脑数字减影血管造影术(DSA)均未发现复发:显而易见,杂交手术室能充分结合显微外科手术和血管内介入治疗的优势,在手术治疗 SMG III-V 级 BAVM 时,切除率高,术后并发症发生率低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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