Nationwide survey of the present status of the therapy of dural arteriovenous fistulas in Japan

日本全国硬脑膜动静脉瘘治疗现状调查

基本信息

批准号：
17591506
负责人：
KUWAYAMA Naoya
金额：
$ 1.41万
依托单位：
University of Toyama
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

项目摘要

We conducted the nationwide surgery on the present status of the treatment of dural AV fistulas (dAVF) in Japan. The questionnaires were sent to all of 388 neurointerventionalists (268 clinics) certified by the Japanese Society of Neuroendovascular Therapy to ask the patients dermography and details of treatment between 05 January and 06 December. The clinical data of 863 patients were reported by 92 clinics. 45% of the patients were men and 55% were women. Patients' mean age was 64.0+/-13.2 years. The cavernous sinus (CS) was involved in 396 patients(45.9%), the transverse-sigmoid sinus (TSS) in 230 (26.7%), the spinal cord in 51 (5.9%), the anterior condylar confluence (ACC) in 43 (5.0%), the tentorium in 41 (4.8%), the superior sagittal sinus in 28(3.2%), the craniocervical junction (CCJ) in 21 (2.4%), the cranial vault in 21 (2.4%), the anterior cranial base (ACB) in 18 (2.1%), and the confluence of the sinus in 12 (1.4%). 719 (83%) patients were treated with endovascular method, 61(7%) with surgical method, and 37(4%) with radiosurgical method. The radiological results were complete obliteration in 66% of the patients, subtotal in 17%, partial in 11%. Treatment complications were reported in 4.1% of the patients. The mean modified Rankin Scale was 1.4 before, and 0.6 after treatment. The results of the treatment of the CS and TSS lesions were acceptable and satisfactory. The analysis of the complications reported suggested the endovascular treatment sometimes tended to be selected inappropriately in the ACB and CCJ lesions.

我们针对日本硬脑膜动静脉瘘（dAVF）的治疗现状进行了全国范围的手术。调查问卷被发送给日本神经血管内治疗学会认证的所有 388 名神经介入医生（268 个诊所），询问患者 1 月 5 日至 12 月 6 日期间的皮肤造影和治疗细节。 92家诊所报告了863名患者的临床数据。 45%的患者是男性，55%是女性。患者的平均年龄为 64.0+/-13.2 岁。海绵窦（CS）396例（45.9%），横乙状窦（TSS）230例（26.7%），脊髓51例（5.9%），前髁汇合处（ACC）43例(5.0%)、小脑幕 41 (4.8%)、上矢状窦28 例（3.2%），颅颈交界处（CCJ） 21 例（2.4%），颅顶 21 例（2.4%），前颅底（ACB） 18 例（2.1%），窦汇合处 21 例（2.4%）。 12（1.4%）。 719例（83%）患者采用血管内治疗，61例（7%）患者采用手术治疗，37例（4%）患者采用放射外科治疗。放射学结果显示，66% 的患者完全消失，17% 的患者部分消失，11% 的患者部分消失。 4.1% 的患者报告出现治疗并发症。治疗前平均改良Rankin量表为1.4，治疗后为0.6。 CS和TSS病变的治疗结果是可以接受和满意的。对报告的并发症的分析表明，对于 ACB 和 CCJ 病变，血管内治疗有时往往选择不当。