PDF(Pubmed)
Abstract：
BACKGROUND: An arteriovenous fistula is an abnormal arteriovenous shunt between an artery and a vein, which often leads to venous congestion in the central nervous system. The blood flow near the fistula is different from normal artery flow. A novel method to detect the abnormal shunting flow or pressure near the fistula is needed.
METHODS: A 76-year-old woman presented to the authors\' institute with progressive right upper limb weakness. Right vertebral angiography showed a fistula between the right extracranial vertebral artery (VA) and the right vertebral venous plexus at the C7 level. The patient underwent endovascular treatment for shunt flow reduction. Before the procedure, blood pressures were measured at the proximal VA, distal VA near the fistula, and just at the fistula and drainer using a microcatheter. The blood pressure waveforms were characteristically different in terms of resistance index, half-decay time, and appearance of dicrotic notch. The fistula was embolized with coils and N-butyl cyanoacrylate solution.
CONCLUSIONS: During endovascular treatment, the authors were able to digitally record the vascular pressure waveform from the tip of the microcatheter and succeeded in calculating several parameters that characterize the shunting flow. Furthermore, these parameters could help recognize the abnormal blood flow, allowing a safer endovascular surgery.
METHODS: A 76-year-old woman presented to the authors\' institute with progressive right upper limb weakness. Right vertebral angiography showed a fistula between the right extracranial vertebral artery (VA) and the right vertebral venous plexus at the C7 level. The patient underwent endovascular treatment for shunt flow reduction. Before the procedure, blood pressures were measured at the proximal VA, distal VA near the fistula, and just at the fistula and drainer using a microcatheter. The blood pressure waveforms were characteristically different in terms of resistance index, half-decay time, and appearance of dicrotic notch. The fistula was embolized with coils and N-butyl cyanoacrylate solution.
CONCLUSIONS: During endovascular treatment, the authors were able to digitally record the vascular pressure waveform from the tip of the microcatheter and succeeded in calculating several parameters that characterize the shunting flow. Furthermore, these parameters could help recognize the abnormal blood flow, allowing a safer endovascular surgery.
摘要：
背景：动静脉瘘是动脉和静脉之间的异常动静脉分流，这通常会导致中枢神经系统的静脉充血。瘘管附近的血流量与正常动脉流量不同。需要一种新的方法来检测瘘管附近的异常分流流量或压力。
方法：一位76岁的女性向作者介绍了患有进行性右上肢无力的研究所。右侧椎管造影显示右侧颅外椎动脉（VA）和右侧椎静脉丛之间的瘘在C7水平。患者接受了血管内治疗以减少分流流量。在程序之前，在近端VA测量血压，瘘管附近的远端VA，使用微导管在瘘管和引流器处。血压波形在阻力指数方面的特征不同，半衰减时间，和重病缺口的外观。用线圈和氰基丙烯酸正丁酯溶液栓塞瘘管。
结论：在血管内治疗期间，作者能够以数字方式记录来自微导管尖端的血管压力波形,并成功计算出表征分流流量的几个参数.此外，这些参数可以帮助识别异常的血流，允许更安全的血管内手术。
方法：一位76岁的女性向作者介绍了患有进行性右上肢无力的研究所。右侧椎管造影显示右侧颅外椎动脉（VA）和右侧椎静脉丛之间的瘘在C7水平。患者接受了血管内治疗以减少分流流量。在程序之前，在近端VA测量血压，瘘管附近的远端VA，使用微导管在瘘管和引流器处。血压波形在阻力指数方面的特征不同，半衰减时间，和重病缺口的外观。用线圈和氰基丙烯酸正丁酯溶液栓塞瘘管。
结论：在血管内治疗期间，作者能够以数字方式记录来自微导管尖端的血管压力波形,并成功计算出表征分流流量的几个参数.此外，这些参数可以帮助识别异常的血流，允许更安全的血管内手术。
