29. 硬膜動静脈奇形の治療-主にIvalonを用いたcatheter embolizationについて

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This paper reports our experiences of transcatheter embolization using Ivalon particles in nine cases of dural arteriovenous malformations (AVM). The embolization was done for the purpose of decreasing abnormal arteriovenous shunts.<BR>Catheterization was undertaken through the femoral artery in six cases and through the common carotid artery in three. Ivalon (polyvinyl alcohol foam) particles,0.5×0.5×0.5mm in mean size, were instilled with normal saline and contrast material half-and-half. The emboli were injected as gently as possible under an image intensifier.<BR>In eight cases of dural AVMs, embolization resulted in a remarkable decrease in the size of the malformation. One patient had a small dural AVM in the posterior fossa dura, which was occluded. In two cases of malformation, a CT scan was done after embolization, and both showed a decrease of the contrast enhancement lesions, considered intracranial drainage veins of the malformations. Most patients with malformations, had clinically favorable results when treated with embolization alone.<BR>Subsequent to embolization, irradiation was performed in four patients with idiopathic CCF and the malformation disappeared completely in two cases and partially in one.<BR>No major side effects were encountered in this series. We should pay attention to vascular anomalies before embolization to prevent possible catastrophes.
The Japanese Society on Surgery for Cerebral Strokeの論文