Efficacy of emergency one-stop hybrid operation in ruptured and hemorrhagic high-grade brain arteriovenous malformations
10.3760/cma.j.cn115354-20230705-00370
- VernacularTitle:破裂出血的高分级脑动静脉畸形急诊一站式复合手术治疗效果分析
- Author:
Jiao CHENG
1
;
Bingwei SONG
;
Liang HE
;
Ke YAN
;
Linhai SHEN
;
Kai HU
;
Yong ZHEN
Author Information
1. 大连医科大学扬州临床医学院神经外科，扬州 225000
- Keywords:
High-grade brain arteriovenous malformation;
One-stop hybrid operation;
Endovascular treatment
- From:
Chinese Journal of Neuromedicine
2023;22(10):1044-1048
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and effectiveness of emergency one-stop hybrid operation in ruptured and hemorrhagic high-grade brain arteriovenous malformations (BAVMs).Methods:Twelve patients with ruptured and hemorrhagic high-grade BAVMs who underwent emergency one-stop hybrid operation were chosen. The clinical data and efficacy of these patients were analyzed retrospectively.Results:All patients completed surgery successfully. Embolization combined with BAVMs resection was performed in 4 patients, BAVMs resection under digital subtraction angiography (DSA) was performed in 4 patients, embolization combined with balloon-assisted BAVMs resection was performed in 1 patient, balloon-assisted BAVMs resection under DSA was performed in 1 patient, embolization combined with BAVMs resection and aneurysm clipping was performed in 1 patient, and BAVMs resection combined with aneurysm clipping under DSA was performed in 1 patient. Intraoperative DSA showed residual vascular malformation in 1 patient and complete resection in other 11 patients. No surgical complications occurred. Two patients presented symptoms of delayed epilepsy after discharge. Six months after operation, 8 patients had good prognosis (Glasgow Outcome Scale [GOS] scores≥4), 4 had poor prognosis (GOS scores of 1-3), and no death occurred. CTA or DSA in all patients 6 months after operation found no residual or recurrent vascular lesions.Conclusion:Emergency one-stop hybrid operation has high complete occlusion rate and low surgical complication incidence in ruptured and hemorrhagic high-grade BAVMs, which is worthy of clinical application.
