Study On Correlation Of Angioarchitecture And Post-embolic Complication In Cerebral Arteriovenous Malformation

Objective:Studying intravascular embolization treatment of cerebral dynamic venous malformation (cerebral arteriovenous malformation, cAVM) cases, vascular architectural features, cure of embolization technique, postoperative complications and incidence and explore endovascular embolization in the treatment of cAVM complications due to the original and build risk factors associated with vascular and cAVM cure embolic provides the basis and guidance, improve the efficacy of cAVM intravascular embolization in the treatment of, reduce incidence of complications of embolization treatment.Mateerials and methods:Analysis of our department 20092015 in endovascular embolization in the treatment of 60 cases of cAVM patients clinical data, analysis of cAVM patients before the angioarchitecture, including vascular malformation group size, location, type, and the blood supply of arterial vessels, source and artery characteristics, drainage vein, venous drainage direction and dilatation of venous drainage. All patients under general anesthesia using Onyx 18- to cure the embolism to intravascular embolization and postoperative continuous narcosis state controlled hypotension to the preoperative mean arterial pressure of 2/3 levels, and continued for 24 to 72 hours. To sum up the clinical effect and the complications of endovascular embolization and the reasons for the complications. The angioarchitecture of factors including vascular malformation group size, location, type, and the blood supply of arterial vessels, source and artery characteristics, number of venous drainages, venous drainage and drainage vein dilatation as independent factors were analyzed by single factor analysis, then the single factor node fruit of related factors as the dependent variable and the complications as independent variables for multivariate logistic regression analysis, excluding the mutual effects among the factors and ultimately selected complications were significantly related to the vascular architecture of factors. The SPSS 19 was statistically significant and p<0.05 was statistically significant.Reults:60 cases of patients with cAVM were effective in the treatment of embolization, Patients underwent a total of 81 embolization sessions, with 42 having 1 session,15 having 2 sessions,3 having 3 sessions, each volume of the onyx injection 0.3～12ml:(on average).31 cases of patients to be cured of embolism and the rest did not complete occlusion of 29 patients with above than 80% occlusion was obtained in 8 cases,50%～80% occlusion was obtained in 14 cases, less than 50% occlusion was obtained in 7 cases, and Statistical analysis shows that curative embolization of cAVM was not related to the post-embolic complication.60 patients in this group there were 10 cases of complications, of which 5 were hemorrhagic,4 were ischemic (including 1 were hemorrhagic and microcatheters retention),1 were hemorrhagic and ischemic. Except for hemorrhagic complications, patients with ischemic complications caused the right limb hemiplegia, and the other patients were improved or no significantly worse than the preoperative symptoms, no deaths. Use of SPSS analysis software in the single factor model analysis that vascular malformation group size, feeding artery type and vein drainage direction and drainage vein dilatation,which were related to the occurrence of the post-embolic complication. Other angioarchitecture facters including vascular malformation group position, type, feeding arterial vessels, source and drain venous vessels were not related to the post-embolic complication. The AVM size, characteristics of feeding arterial vessels, venous drainage direction and expansion of the draining vein as the dependent variable and the complications as independent variables for multivariate logistic regression analysis showed that in large arteriovenous malformation, perforator artery, simple deep venous drainage is closely related with the occurrence of complications, and single factor analysis of drainage vein dilatation were excluded.Conclution:1. Complications of the row control conditions, embolization degree and complications incidence has nothing to do, Curative embolization overall complication rate is not significantly increased.2. The large vascular malformation, perforating arterial vessels supply, only to deep venous drainage is risk factors of the complication of Curative embolizationt, vascular malformation group position, vascular malformation types of groups, the number of arteries, blood supply artery origin, drainage vein count and drainage vein expansion unrelated to the occurrenceand of embolization complications.3. The increase of cerebral arteriovenous malformation angioarchitecture of understanding and operation specification fine operation, active prevention of complications, decrease the incidence of thromboembolic complications.