医学
氰基丙烯酸酯
栓塞
导管
动静脉畸形
放射科
血管内治疗
气球
外科
动脉瘤
胶粘剂
有机化学
化学
图层(电子)
作者
Matthew Triano,Jacques Lara‐Reyna,Alexander J. Schüpper,Kurt Yaeger
标识
DOI:10.1016/j.wneu.2020.06.118
摘要
Endovascular embolization of cerebral arteriovenous malformations (AVMs) originally entailed delivery of N-butyl cyanoacrylate glue to the nidus via a flow-directed microcatheter. Within the past decade, several new liquid embolic agents and novel microcatheter technologies have become available that have improved the ease of use and efficacy of endovascular therapies for AVMs. Nonadhesive copolymers, such as Onyx and Precipitating Hydrophobic Injectable Liquid, have largely replaced N-butyl cyanoacrylate given a lower risk of catheter entrapment. The emergence of balloon microcatheters has allowed for improved protection of the normal cerebral vasculature and has improved the penetration of liquid embolics into large AVMs, ultimately reducing procedure times and radiation exposure. Finally, several detachable tip microcatheters have been developed to facilitate removal of the catheter from hardened liquid embolic cast, preventing the morbidity associated with distal catheter entrapment. This article reviews the embolic agents and microcatheters currently available for the treatment of cerebral AVMs in the United States as well as the data demonstrating the safety and efficacy of these devices.
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