一个横向的西格 sinus 持续的动脉静脉,具有多隔间的西格 sinus 架构,涉及正常的静脉排水和通道外流
Yusuke Otsu1, Shuichi Tanoue2, Hideaki Shigematsu3
1Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Journal of neuroendovascular therapy
|March 9, 2026
概括
一种罕见的持续性动脉静脉 (dAVF) 与完全隔离的西格状鼻被通过静脉 Onyx 栓塞成功治疗. 这种方法保持了正常的静脉排水,突出了为量身定制的内血管策略识别鼻细分的重要性.
科学领域:
- 神经外科 神经外科
- 干预性神经放射学 干预性神经放射学
- 血管神经学 血管神经学
背景情况:
- 持续性动脉静脉 (dAVFs) 是持续性动脉和静脉之间的异常连接.
- 横向西格 sinus (TSS) dAVFs是dAVFs的一个子集,通常呈现出特定的静脉排水模式.
- 西格状鼻的完整内部隔离是一种罕见的解剖变异,可能会使dAVF管理复杂化.
研究的目的:
- 报告一个罕见的横向-sigmoid sinus 长期动脉静脉 (TSS dAVF) 病例,其完全是sigmoid sinus 的内部隔离.
- 为了描述这种复杂的daVF的成功穿静脉栓塞,同时保持正常的静脉回归.
- 强调手术前成像在识别鼻细分中的重要性,以定制内血管治疗策略.
主要方法:
- 一名69岁的男性患者出现了脉动性耳声.
- 数字减去血管造影 (DSA) 揭示了TSS dAVF,并详细说明了西格状鼻的分隔.
- 使用3D旋转血管造影和融合成像来划分隔间.
- 通过静脉栓塞使用SOFIA Select微导管和Onyx 18进行了,向了分流区.
- 术后血管造影证实了囊封闭,并保留了皮质静脉排水.
主要成果:
- 通过通过静脉 Onyx 栓塞成功封闭了 TSS dAVF.
- 完全切断西格状鼻的内部隔离,允许分离分流和正常皮质静脉排水.
- 患者经历了 tinnitus 的部分解消,并在出院时获得了 1 的修改的兰金级评分.
- 血栓形成后血管造影显示没有反流,并保留了前级静脉流.
结论:
- 识别长期鼻区分对于计划有效的daVF治疗至关重要.
- 以详细的手术前成像为指导的分区特异性栓塞可以成功治疗复杂的dAVF,同时保持生理静脉排水.
- 血栓形成诱导的隔离可能是这种罕见解剖学的根本原因,需要个性化的内血管方法.
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