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Endovascular treatment of cerebral arterio-venous мalformations and carotido- cavernous fistulae


Author: Parpauţ Vladimir
Degree:doctor of medicine
Speciality: 14.00.28 - Neurosurgery
Year:2008
Scientific adviser: Grigore Zapuhlih
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Mihai Gavriliuc
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:

Status

The thesis was presented on the 17 September, 2008
Approved by NCAA on the 23 October, 2008

Abstract

Adobe PDF document – 3.57 Mb / in romanian

Thesis

CZU 616.831-089+616.13/.14

Adobe PDF document 16.00 Mb / in romanian
152 pages

Keywords

arteriovenous malformation, carotid-cavernous sinus fistula, endovascular treatment, catheter with balloon, quality of life.

Summary

Work is devoted to the analysis of 41 cases оf endovascular treatments by method Serbinenkо of patients with аrteriо-venous mаlformations (20 patients) and carotidocavernous fistulae (21 patients). Patients have been in details surveyed clinically, and also by means of additional methods such as ultrasonic dopplerography (18 patients), a computer tomography (22 patients), a magnetic resonance (8 patients) and conventional аngiography (41 patients).

The most frequent clinical displays of АVМ and СCF were a headache (86 % of patients), a convulsive syndrome (52 % of patients), pulsing noise in a head (50 % of patients), and also eye movement frustration (18 % of patients). The received results have proved that the given vascular pathology is as a matter of fact benign, however the qualitative outcome of operative endovascular treatments depends on several factors: time of statement of the diagnosis (up to irreversible decompensation of the cerebral blood flow), localizations and the areas of defect of a vascular wall.

The special attention deserves, according to the early and late results of treatment, preoperative preparation of the patients by Matas method, which at duration of 180 minutes within 24 hours allows to exclude completely intraoperational ischemic infringements of the blood flow.

The research proves the perspectivity of the given method of treatment alongside with other modern technologies, proceeding from its availability and criterion cost - efficiency.