硬脑膜动静脉瘘经动脉栓塞过程中“玛瑙线”向引流静脉的毛球样迁移:一例病例报告和实验验证。

IF 1.2 Q4 CLINICAL NEUROLOGY
Neurointervention Pub Date : 2023-11-01 Epub Date: 2023-07-26 DOI:10.5469/neuroint.2023.00185
Tetsuya Ioku, Tomotaka Ohshima, Mao Yokota, Naoki Matsuo, Shigeru Miyachi
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引用次数: 0

摘要

使用Onyx经动脉栓塞是治疗硬脑膜动静脉瘘(DAVFs)的一种行之有效的方法。然而,当玛瑙迁移到静脉侧,损害引流静脉时,可能会出现并发症。我们遇到了一个案例,通过动脉侧注射的玛瑙误入颈静脉,形成了一个毛球状结构。我们的研究旨在调查这种不寻常现象的潜在机制。我们假设玛瑙在穿过极窄的开口时会沉淀成线状。为了测试这一点,我们从注射器中通过27号针头将Onyx挤出到一个装有流动水的硅胶管中。通过改变流速,我们观察到了玛瑙的硬化行为。在慢速流动的情况下,挤出的玛瑙在针尖处快速凝固,形成圆形团块。相反,高速流动导致玛瑙分散成小块。我们在连续的慢速流动条件下成功地复制了“Onyx线程”的形成,类似于我们的情况。在动静脉分流疾病的动脉栓塞过程中,当玛瑙意外地通过一个微小的开口迁移到引流静脉时,就会出现这种现象。早期识别和采取适当措施是预防引流静脉和肺系统闭塞并发症的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Hairball-Like Migration of "Onyx Threads" into the Draining Vein during Transarterial Embolization of a Dural Arteriovenous Fistula: A Case Report and Experimental Validation.

Hairball-Like Migration of "Onyx Threads" into the Draining Vein during Transarterial Embolization of a Dural Arteriovenous Fistula: A Case Report and Experimental Validation.

Hairball-Like Migration of "Onyx Threads" into the Draining Vein during Transarterial Embolization of a Dural Arteriovenous Fistula: A Case Report and Experimental Validation.

Transarterial embolization using Onyx is a well-established treatment for dural arteriovenous fistulas (DAVFs). However, complications can arise when Onyx migrates into the venous side, impairing the draining veins. We encountered a case where Onyx, injected through the arterial side, strayed into the jugular vein, forming a hairball-like structure. Our study aimed to investigate the underlying mechanism of this unusual phenomenon. We postulated that Onyx precipitates into thread-like shapes when passing through extremely narrow openings. To test this, we extruded Onyx from a syringe through a 27-gauge needle into a silicone tube with flowing water. By varying the flow speed, we observed the hardening behavior of Onyx. Under slow flow, the extruded Onyx quickly solidified at the needle tip, forming a round mass. Conversely, high-speed flow resulted in Onyx being dispersed as small pieces. We successfully replicated the formation of "Onyx threads" under continuous slow flow conditions, similar to our case. This phenomenon occurs when Onyx unexpectedly migrates to the draining vein through a tiny opening during transarterial embolization for arteriovenous shunt diseases. Early recognition and appropriate measures are necessary to prevent occlusive complications in the draining veins and the pulmonary system.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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