脳外科疾患における経大腿カテーテル塞栓術

Embolization and Detached Balloon Occlusion by the Femoral Route in Craniofacial Lesions

I．はじめに

　血管造影の手技が発達するにつれて，選択的あるいは超選択的血管造影が可能となり，それに伴い，近年intravascular surgeryもめざましい発展を遂げつつある．

　すなわち，外頸動脈系が関与する血流豊富な腫瘍（髄膜腫，頸静脈球腫瘍，顔面血管腫，副鼻腔や咽頭の腫瘍など），顔面および頭皮動静脈奇形，頸動脈海綿静脈洞瘻，硬膜動静脈奇形あるいは脳動静脈奇形に対して，力テーテル塞栓術が一般に行われてきた．

Embolization and detached balloon occlusion by the femoral route were performed in 45 cases: 19 cases of meningiomas, 5 of scalp arteriovenous mal-formations (AVMs), 4 of dural AVMs, 6 of cerebral AVMs, 8 of facial angiomas and 3 of carotid cavernous sinus fistulas (CCFs); and favorable results were attained.

In meningiomas, there is only a short interval between the embolization and the removal of tumor (we usually perform the embolization a couple of days before the removal), and we use Gelfoam as embolus material. We aim at central tumor embolization with small emboli.