1. n-butyl -cyanoacrylate yog cov neeg sawv cev tshaj plaws ntawm cov ntaub nplaum ua kua embolic, thiab nws tau siv dav thoob plaws ntiaj teb. Cov kua NBCA monomer thiab pawg nucleophilic hauv cov ntshav tuaj yeem ua polymerized tam sim hauv cov ntshav los tsim cov khoom nplaum, uas tsis yog degradable ntawm lub intima ntawm cov hlab ntsha. Cov txheej txheem no yuav siv sij hawm 15 mus rau 40 vib nas this los polymerize hauv saline, tab sis ntawm 5 feem pua polymerization tsis tshwm sim hauv cov kua qab zib, uas ua rau yooj yim rau kev ua haujlwm embolization. Flushing lub microcatheter nrog 5 feem pua cov kua qab zib ua ntej thiab tom qab embolization tuaj yeem tiv thaiv nws cov polymerization hauv microcatheter thiab thaiv cov microcatheter. Nyob rau tib lub sijhawm, ntxiv qhov tsim nyog ntawm tantalum hmoov tuaj yeem txhim kho kev txhim kho yam tsis muaj kev cuam tshuam rau lub sijhawm polymerization ntawm cov kua nplaum. Rau cov kab mob AVM sib txawv, qhov sib txawv ntawm cov kua nplaum tuaj yeem ua tiav tib yam embolization nyhuv, tab sis lub sij hawm ntawm cov kua nplaum polymerization txawv. Qhov loj tshaj qhov tsis zoo ntawm cyanoacrylate kua embolic cov ntaub ntawv sawv cev los ntawm NBCA kua nplaum yog "cov raj nplaum", uas yog tshwj xeeb rau cov ntaub nplaum embolic. Vim nws qhov nplaum, lub sijhawm txhaj tshuaj yog txwv, thiab lub catheter yuav tsum tau muab tshem tawm tam sim tom qab txhaj tshuaj, txwv tsis pub nws yuav muaj kev pheej hmoo ntawm microcatheter adhering rau qhov deformity. Qhov no yuav tsum tau tus neeg teb xov tooj kom muaj kev nplua nuj nyob rau hauv kev txhaj tshuaj kua nplaum, paub qhov concentration ntawm cov kua nplaum, tuav lub sijhawm txhaj tshuaj thiab txhaj tshuaj, nruj me ntsis tswj cov reflux, thiab tshem tawm cov microcatheter hauv lub sijhawm.
NBCA kua nplaum kev npaj thiab kev siv tshuab: NBCA kua nplaum yog X-ray-permeable mus tas li kua embolism khoom, uas coagulates tom qab sib cuag nrog cov ntshav. Lub sijhawm coagulation muaj feem xyuam rau qhov concentration ntawm NBCA kua nplaum, thiab nws tsis coagulate thaum nws sib cuag nrog cov kua nplaum thiab lipiodol. Yog li ntawd, raws li lub sijhawm arteriovenous ncig ntawm AVM, nws yog ib qho tsim nyog yuav tsum tau ntxiv cov roj iodized uas tsim nyog kom ua tiav lub hom phiaj ntawm kev tsim thiab diluting hauv fluoroscopy. Yog tias tus nqi ntws ntawm AVM yog ceev heev, NBCA ntshiab tuaj yeem ntxiv nrog cov nqi tsim nyog ntawm tantalum hmoov. Raws li qhov loj me me, cov ntshav khiav nrawm, tsis kam, ntshav cov hlab ntsha tuab, thiab cov hlab ntsha ntawm cov hlab ntsha tau kawm los ntawm kev xaiv qhov sib txawv ntawm qhov sib txawv angiography, NBCA kua nplaum nrog ntau qhov sib txawv tau npaj nrog cov roj iodized. Feem ntau siv concentration yog 17 feem pua ~ 33 feem pua. Flow velocity, dubbed concentration yog 50 feem pua lossis 66 feem pua. Ib lub koob txhaj tshuaj 1ml yog siv rau kev txhaj tshuaj, thiab qhov ntim txhaj tshuaj yog qhov ntim ntawm AVM qhov txhab tau sau tseg thaum lub sijhawm superselective angiography. Tshem tawm qhov chaw ua haujlwm nrog cov kua qabzib ua ntej txhaj tshuaj, suav nrog kev rov ua kom cov kua qabzib ntau ntxiv hauv microcatheter li 3 zaug lossis ntau dua, yaug cov koob txhaj tshuaj thiab microcatheter txuas, nrog rau tag nrho cov khoom siv thiab cov ntaub ntawv ntsig txog kev txhaj tshuaj NBCA kua nplaum. Kev txhaj tshuaj ntawm NBCA kua nplaum nyob rau hauv DSA fluoroscopy tuaj yeem qhia meej tias qhov sib txawv ntawm NBCA kua nplaum hauv AVM qhov txhab. Thaum NBCA kua nplaum nkag mus rau hauv cov hlab ntsha los yog rov qab mus rau hauv cov hlab ntshav, cov tshuaj raug tso tseg thiab cov microcatheter tau nrawm nrawm. Cov txheej txheem txhaj tshuaj zoo tshaj plaws yog cov kua nplaum NBCA sib npaug sib npaug hauv AVM qhov txhab los tsim cov cam khwb cia mus tas li. Yog tias muaj ntau cov hlab ntsha, rov ua cov kauj ruam saum toj no rau ntau yam embolizations. Yog tias nws yog AVM loj, embolization tuaj yeem ua tiav hauv theem. Angiography tau ua tam sim ntawd thiab 15 feeb tom qab ua haujlwm los ntsuas qhov embolism, thiab MRI / MRA kev kuaj mob tau ua rau 6 lub hlis mus rau ib xyoos tom qab kev ua haujlwm los ntsuas cov txiaj ntsig ntev.
2. GLUBRAN-2 kua nplaum NBCA-MS yog cov kua nplaum nplaum uas ua los ntawm GE Company hauv Ltalis. Nws tseem hu ua GLUBRAN -2 kua nplaum, feem ntau hu ua Italian kua nplaum thiab cov kua nplaum phais. Lub sijhawm polymerization tau txuas ntxiv los ntawm 15 mus rau 40 vib nas this mus rau 60 mus rau 90 vib nas this, uas muab lub sijhawm muaj txiaj ntsig rau lub sijhawm txaus thiab tsis sib xws ntawm embolized intracranial AVM, yog li zam lub microcatheter sticking vim ntxov ntxov polymerization ntawm embolization kua nplaum yav dhau los. Risk ntawm hemorrhage nrog daig tube los yog extubation. Nws txoj kev npaj thiab kev txhaj tshuaj yog tib yam li NBCA kua nplaum. Nws yog cov khoom siv nplaum ua kua embolism dav siv hauv tsev thiab txawv teb chaws tam sim no, thiab nws tuaj yeem hais tau tias yog ib qho khoom kho dua tshiab ntawm NBCA.
3. Tus tshiab kua embolic tus neeg sawv cev Onyx Onyx yog ib tug yooj yim sib tov ntawm vinyl cawv copolymer yaj nyob rau hauv dimethyl sulfoxide, nyob rau hauv uas micronized tantalum hmoov yog ntxiv kom nws pom nyob rau hauv X-ray. Thaum cov polymer los rau hauv kev sib cuag nrog cov ntshav los yog ib qho kev daws teeb meem, cov kuab tshuaj DMSO sai sai, EVOH crystallizes tawm, thiab maj mam solidifies los ntawm sab nraud mus rau sab hauv xws li lava, thiab nws cov kua nruab nrab tseem tuaj yeem ntws, thiab thaum kawg tsim ib daim txhuam cev- zoo li cov khoom uas muaj tan hmoov. Raws li cov khoom siv embolic rau intracranial AVM, piv nrog rau lwm cov ntaub ntawv ua kua embolic, cov yam ntxwv ntawm Onyx tuaj yeem ua tiav raws li hauv qab no: ① Nws muaj kev tswj tau zoo thiab feem ntau tsis ntws nrawm nrog cov ntshav ntws zoo li diluted NBCA; Diffusion rau pem hauv ntej; ③ Lub diffusion ntawm Onyx nyob rau hauv lub deformity yog nyob rau hauv qhov kev txiav txim ntawm bolus txhaj quab yuam thiab hemodynamic quab yuam, thiab nws diffuses nrog lub siab gradient los ntawm siab mus rau qis. Muaj 3 qhov sib txawv ntawm Onyx haum rau AVM lossis fistula embolization. Raws li qhov sib txawv ntawm EVOH thiab DMSO, peb qhov ntau ntawm Onyx yog: Onyx-18 (6 feem pua EVOH ntxiv rau 94 feem pua DMSO), Onyx-20 (6.5 feem pua EVOH ntxiv rau 93.5 feem pua DMSO) thiab Onyx -34 (8 feem pua EVOH ntxiv rau 92 feem pua DMSO), tam sim no feem ntau siv hauv Suav teb yog Onyx-18.