METHOD FOR INTRAOPERATIVE DOPPLER CONTROL OF RADICALITY OF ARTERIOVENOUS MALFORMATION EMBOLISATION

摘要

FIELD: medicine.;SUBSTANCE: invention concerns medicine, particularly neurosurgery. A DMSO-compatible microcatheter for administering the non-adhesive composition Onyx is inserted endovacularly through an arteriovenous malformation (AVM) afferent intranidally. A reinforced microcatheter of an internal diameter not less than 0.43 mm (0.17 in) is inserted into the afferent in the proximal direction from an origin of intact arteries not involved into the AVM blood flow; an intravascular conductor Combowire is inserted through the microcatheter into an arterial lumen. Immediately before an embolisation procedure and throughout the operation, Combomap apparatus is used for intravascular Doppler sonography with bypass pattern fixation; the pressure is measured in the AVM afferent at a distal end of the intravascular conductor Combowire and in a radial artery. The blood flow velocity in the AVM afferent and the pressure values in the radial artery and in the AVM afferent are indicated by Combomap apparatus with using an analogue-to-digital converter and programmed to derive hemodynamic values in the embolised AVM afferent - P and V, Q and E. The intraoperative real-time dependency diagrams of V and P, Q and E are plotted; the composition Onyx is administered until a linear blood velocity in the AVM afferent is reduced; the bypass pattern regresses completely; the AVM afferent pressure is levelled with the radial artery pressure; the plotted hemodynamic values V and P, Q and E tend to decrease. That is followed by a control angiography, and if the radicality of the AVM exclusion has been proved, an endovascular instrument is removed, and the operation is completed.;EFFECT: method enables minimising the quantity of the angiography stages that substantially reduces the intraoperative radiation exposure accompanying the endovascular operation.;2 ex, 7 dwg