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目的探讨血管内栓塞联合显微外科手术治疗位于功能区的大型脑动静脉畸形(AVM)的方法。方法采用微导管超选择性插管用NBCA、游离弹簧圈、真丝线段栓塞后联合显微外科手术切除8例脑AVM病例。结果栓塞联合手术的8例脑AVM病例获得全切,术中出血量均明显偏低,无神经功能缺失加重,无死亡率。结论血管内栓塞联合显微外科手术能够提高Spetzler-Martin高级别脑AVM的治愈率,降低手术风险;大型的和位于重要功能区的脑AVM的安全、有效治疗方式。
Objective To investigate the method of endovascular embolization combined with microsurgery for the treatment of large cerebral arteriovenous malformations (AVMs) located in functional areas. Methods Eight cases of brain AVM were excised by micro catheter cannulation with NBCA, free coil and silk thread embolization combined with microsurgery. Results Embolization combined with surgery in 8 cases of AVM cases were fully resected, the amount of bleeding were significantly lower, no increase in neurological deficits, no mortality. Conclusions Endovascular embolization combined with microsurgery can improve the cure rate of Spetzler-Martin high-grade brain AVM and reduce the surgical risks. It is a safe and effective treatment for large-scale and brain AVM in important functional areas.