Bharathi D Jagadeesan, Andrew W Grande, Ramachandra P Tummala
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引用次数: 12
摘要
背景/目的:柔性双腔球囊微导管已被用于乙烯乙烯醇共聚物(Onyx)脑动静脉畸形(AVMs)的球囊辅助栓塞(BAE)。然而，在使用这些微导管的BAE中，有血管破裂和微导管潴留的报道。使用超柔顺球囊微导管(Scepter XC;Microvention, Tustin, CA, USA)可以帮助避免BAE中颅底血管破裂。我们在此报告使用球囊微导管治疗BAE的经验。方法:本回顾性研究纳入2012年6月至2017年3月在我院接受脑动静脉畸形BAE治疗的患者。结果:采用超顺性Scepter XC球囊微导管治疗脑AVMs患者23例，年龄44.3±16.7岁(0 ~ 65岁)。共40条颅内血管(39条颅底动脉和1条颅底静脉)在30个单独的疗程中插管和栓塞。在所有病例中，球囊微导管均可成功推进至AVM病灶。每次注射平均2.4±1.7 mL (0.65-4.6 mL)的Onyx。没有血管破裂、微导管滞留或中风的病例。结论:超顺性球囊微导管的应用安全有效，增加了BAE治疗AVM的经验。
Safety and Feasibility of Balloon-Assisted Embolization with Onyx of Brain Arteriovenous Malformations Revisited: Personal Experience with the Scepter XC Balloon Microcatheter.
Background/objective: Compliant dual-lumen balloon microcatheters have been used to perform balloon-assisted embolization (BAE) of brain arteriovenous malformations (AVMs) with ethylene vinyl alcohol copolymer (Onyx). However, vessel rupture and microcatheter retention have been reported from BAE using these microcatheters. Using an extra-compliant balloon microcatheter (Scepter XC; Microvention, Tustin, CA, USA) could help avoid pial vessel rupture during BAE. We herein report our experience using this balloon microcatheter for BAE.
Methods: This retrospective study included patients who underwent BAE of brain AVMs at our institution between June 2012 and March 2017.
Results: The extra-compliant Scepter XC balloon microcatheter was used for BAE of brain AVMs in 23 patients aged 44.3 ± 16.7 years (range 0-65 years). A total of 40 intracranial vessels (39 pial arteries and 1 pial vein) were catheterized and embolized during 30 separate sessions. In all instances, the balloon microcatheter could be successfully advanced to the AVM nidus. A mean volume of 2.4 ± 1.7 mL (range 0.65-4.6 mL) of Onyx was injected per session. There were no instances of vessel rupture, microcatheter retention, or stroke.
Conclusion: Utilization of the extra-compliant balloon microcatheter results in safe and effective BAE, which adds to the growing experience with BAE for AVM treatment.
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