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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ymj</journal-id><journal-title-group><journal-title xml:lang="ru">Якутский медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Yakut Medical Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-1905</issn><issn pub-type="epub">2312-1017</issn><publisher><publisher-name>ЯНЦ КМП</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">ymj-2074</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Оптимизация тактики эндоваскулярного лечения больных с большими и гигантскими церебральными артериовенозными мальформациями</article-title><trans-title-group xml:lang="en"><trans-title>Optimization of endovascular treatment tactics of patients with large and giant cerebral arteriovascular malformations</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Байрамов</surname><given-names>Р. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Bajramov</surname><given-names>R. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Байрамов Рафаэль Рафигович – аспирант</p><p>Санкт-Петербург</p></bio><email xlink:type="simple">br_surgeon@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никитин</surname><given-names>П. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikitin</surname><given-names>P. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Никитин Павел Иванович – д.м.н., вед. н.с.</p><p>Санкт-Петербург</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панунцев</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Panuntsev</surname><given-names>V. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Панунцев Владимир Согомонович – д.м.н., проф.</p><p>Санкт-Петербург</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлов</surname><given-names>К. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlov</surname><given-names>K. J.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Орлов Кирилл Юрьевич – к.м.н., с.н.с.</p><p>Санкт-Петербург</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>ФГУ Российский научно-исследовательский нейрохирургический институт им. проф. А.Л.Поленова</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>17</day><month>10</month><year>2025</year></pub-date><volume>0</volume><issue>1</issue><fpage>50</fpage><lpage>54</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Байрамов Р.Р., Никитин П.И., Панунцев В.С., Орлов К.Ю., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Байрамов Р.Р., Никитин П.И., Панунцев В.С., Орлов К.Ю.</copyright-holder><copyright-holder xml:lang="en">Bajramov R.R., Nikitin P.I., Panuntsev V.S., Orlov K.J.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://ymj.elpub.ru/jour/article/view/2074">https://ymj.elpub.ru/jour/article/view/2074</self-uri><abstract><p>Отсутствие единой точки зрения о тактике лечения больных с большими и гигантскими артериовенозными мальформациями способствовало проведению нашего исследования. Применяя принципы поэтапного выключения АВМ из кровообращения на основании ангиоархитектоники, пользуясь возможностями на сегодняшний день современными технологиями, нам удалость повысить радикальность операции за меньшее число этапов и увеличить хорошие результаты у больных с АВМ IV-V градации по Spetzler-Martin.</p></abstract><trans-abstract xml:lang="en"><p>Our investigation was influenced by the absence of common view on endovascular treatment tactics of patients with large and giant cerebral arteriovascular malformations. Using principles of staged AVM obliteration based on angioarchitectonics and modern technological advances, we managed to increase surgical efficacy by less number of stages and to increase good results in patients with AVM of IV-V grades according to Spetzler-Martin.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>артериовенозные мальформации</kwd><kwd>Spetzler-Martin IV-V</kwd><kwd>ангиоархитектоника</kwd><kwd>рацемозное</kwd><kwd>фистулезно-рацемозное</kwd><kwd>ONYX</kwd><kwd>гистоакрил</kwd><kwd>радикальность</kwd><kwd>ивалидизация</kwd><kwd>отдаленный послеоперационный период</kwd></kwd-group><kwd-group xml:lang="en"><kwd>arteriovenous malformation</kwd><kwd>Spetzler-Martin IV-V</kwd><kwd>angioarchitectonics</kwd><kwd>racemose</kwd><kwd>fistula – racemose</kwd><kwd>ONYX</kwd><kwd>histoacryl</kwd><kwd>surgical efficacy</kwd><kwd>invalidity</kwd><kwd>long-term postsurgical follow-up</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Никитин П.И. Принципы хирургии артериовенозных мальформаций головного мозга: автореф. дис. … д-ра мед. наук / П. И. Никитин. –СПб., 2000. – 42 с.</mixed-citation><mixed-citation xml:lang="en">Nikityn P.I., Principles of brain arteriovenous malformations surgery: MD thesis / P.I. Nikityn.- St.Petersburg, 2000.- 42 p.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Филатов Ю. М. Артериовенозные аневризмы больших полушарий мозга (клиника, диагностика и хирургическое лечение): автореф. дис. … д-ра мед. наук / Ю. М. Филатов. – М., 1972. – 32 с.</mixed-citation><mixed-citation xml:lang="en">Filatov J.M. Arteriovenous aneurysms of brain large hemispheres (clinics, diagnostics and surgical treatment): MD thesis / J. M. Filatov. - М, 1972. - 32 p.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Элиава Ш. Ш. Клиника, диагностика и микрохирургическое лечения артериовенозных мальформаций глубинных структур головного мозга: автореф. дис. … д-ра мед. наук / Ш. Ш. Элиава. – М., 1992. – 42 с.</mixed-citation><mixed-citation xml:lang="en">Eliava Sh.Sh. Clinics, diagnostics and microsurgical treatment of arteriovenous malformations of brain deep structures. MD thesis/ Sh.Sh. Eliava.- M., 1992- 42 p.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Cerebral hemodynamics on MR perfusion images before and after bypass surgery in patients with giant intracranial aneurysms / F.Caramia [et al.] // Am j neuroradiol. – 2001. – Vol. 22. – P. 1704 – 10.</mixed-citation><mixed-citation xml:lang="en">Cerebral hemodynamics on MR perfusion images before and after bypass surgery in  patients with giant intracranial aneurysms / F.Caramia [et al.] // Am j neuroradiol. – 2001. – Vol. 22. – P. 1704 – 10.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Treatment of brain arteriovenous malformation by embolization and radiosurgery / Y.P. Gobin [et al.] // J neurosurg. – 1996. –Vol. 85. – P.19 – 28.</mixed-citation><mixed-citation xml:lang="en">Treatment of brain arteriovenous malformation by embolization and radiosurgery / Y.P. Gobin [et al.] // J neurosurg. – 1996. –Vol. 85. – P.19 – 28.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Toward normal perfusion after radiosurgery: perfusion MR imaging with independent component analysis of brain arteriovenous malformations / W.Y. Guo [et al.] // Am j neuroradiol. – 2004. – Vol. 25. – P. 1636 – 44.</mixed-citation><mixed-citation xml:lang="en">Toward normal perfusion after radiosurgery: perfusion MR imaging with independent component  analysis of brain arteriovenous malformations / W.Y. Guo [et al.] // Am j neuroradiol. – 2004. – Vol. 25. – P. 1636 – 44.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Hernesniemi J. Natural History of Arteriovenous Malformanions / J. Hernesniemi // Neurosurgery. – 2008. – Vol. 63, № 5. – P. 1851 – 56.</mixed-citation><mixed-citation xml:lang="en">Hernesniemi J. Natural History of Arteriovenous Malformanions / J. Hernesniemi // Neurosurgery. – 2008. – Vol. 63, № 5. – P. 1851 – 56.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Lundqvist C. Embolization of cerebral arteriovenous malformations. Part II. Aspects on complications and late outcome / C. Lundqvist, G. Wikholm, P. Svendsen // Neurosurgery. – 2004. – Vol. 39. – P. 460 – 67.</mixed-citation><mixed-citation xml:lang="en">Lundqvist C. Embolization of cerebral arteriovenous malformations. Part II. Aspects on complications and late outcome / C. Lundqvist, G. Wikholm, P. Svendsen // Neurosurgery. – 2004. – Vol. 39. – P. 460 – 67.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Factors associated with intracranial hemorrhage in cases of cerebral arteriovenous malformation / U.Mansmann [et al.] // Neurosurgery. – 2000. – V. 46. – P. 272 – 81.</mixed-citation><mixed-citation xml:lang="en">Factors associated with intracranial hemorrhage in cases of cerebral arteriovenous malformation / U.Mansmann [et al.] // Neurosurgery. – 2000. – V. 46. – P. 272 – 81.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation / H. Mast [et al.] // Lancet. – 2005. – V. 350. – P.1065 – 68.</mixed-citation><mixed-citation xml:lang="en">Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation / H. Mast [et al.] // Lancet. – 2005. – V. 350. – P.1065 – 68.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Nakaji P. Management of AVMs / P. Nakaji // Neurol India. – 2005. – Vol. 53, №1. – P.14 – 6.</mixed-citation><mixed-citation xml:lang="en">Nakaji P. Management of AVMs / P. Nakaji // Neurol India. – 2005. – Vol. 53, №1. – P.14 – 6.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Perret G. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section IV. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study / G. Perret, H. Nishioka // J neurosurg. – 1966. – Vol. 25, № 4. – P. 467 – 90.</mixed-citation><mixed-citation xml:lang="en">Perret G. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section IV. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study / G. Perret, H. Nishioka // J neurosurg. – 1966. – Vol. 25, № 4. – P. 467 – 90.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Pollock B.E. Patient outcome after arteriovenous malformation radiosurgery management: results based on 5–14 years follow-up study / B.E. Pollock, D.A. Gorman, R.J. Coffey // Neurosurgery. – 2003. – Vol. 52. –P. 1291 – 96.</mixed-citation><mixed-citation xml:lang="en">Pollock B.E. Patient outcome after arteriovenous malformation radiosurgery management: results based on 5–14 years follow-up study / B.E. Pollock, D.A. Gorman, R.J. Coffey // Neurosurgery. – 2003. – Vol. 52. –P. 1291 – 96.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Management of patients with brain arteriovenous malformations / M. Soderman [et al.] // Eur j radiol. – 2003. – Vol. 46. – P. 195 – 205.</mixed-citation><mixed-citation xml:lang="en">Management of patients with brain arteriovenous malformations / M. Soderman [et al.] // Eur j radiol. – 2003. – Vol. 46. – P. 195 – 205.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Spetzler R. F. A proposed grading system for arteriovenous malformations / R. F. Spetzler, N. A. Martin // J neurosurg. – 1986. – Vol. 6, № 4. – P. 476 – 483.</mixed-citation><mixed-citation xml:lang="en">Spetzler R. F. A proposed grading system for arteriovenous malformations / R. F. Spetzler, N. A. Martin // J neurosurg. – 1986. – Vol. 6, № 4. – P. 476 – 483.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Spetzler R.F. Grading and staged resection of cerebral arteriovenous malformations / R.F. Spetzler, J.M. Zabramsky // Clin neurosurg. – 1990. – Vol. 36. – P. 318 – 337.</mixed-citation><mixed-citation xml:lang="en">Spetzler R.F. Grading and staged resection of cerebral arteriovenous malformations / R.F. Spetzler, J.M. Zabramsky // Clin neurosurg. – 1990. – Vol. 36. – P. 318 – 337.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Effect of age on clinical and morphological characteristics in patients with brain arteriovenous malformation / C. Stapf [et al.] // Stroke. – 2003. – Vol. 34. – P. 2664 – 70.</mixed-citation><mixed-citation xml:lang="en">Effect of age on clinical and morphological characteristics in patients with brain arteriovenous malformation / C. Stapf [et al.] // Stroke. – 2003. – Vol. 34. – P. 2664 – 70.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Valavanis A. The endovascular treatment of brain arteriovenous malformations / A. Valavanis, M. G. Yasargil // Adv tech stand neurosurg. – 1998. – Vol. 24. – P. 131 – 214.</mixed-citation><mixed-citation xml:lang="en">Valavanis A. The endovascular treatment of brain arteriovenous malformations / A. Valavanis, M. G. Yasargil // Adv tech stand neurosurg. – 1998. – Vol. 24. – P. 131 – 214.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Wikholm G. Embolizations of arteriovenous malformations. Part 1. Technique, morphology and complications / G. Wikholm, C. Lundqvist, P. Svendsen // Neurosurgery. – 2004. – Vol. 39. – P.448 – 57.</mixed-citation><mixed-citation xml:lang="en">Wikholm G. Embolizations of arteriovenous malformations. Part 1. Technique, morphology and complications / G. Wikholm, C. Lundqvist, P. Svendsen // Neurosurgery. – 2004. – Vol. 39. – P.448 – 57.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Clinical risks and surgical results of patients with arteriovenous malformations / J. Zhao [et al.] // Surg neurol. – 2005. – Vol. 63. – P. 156 – 61.</mixed-citation><mixed-citation xml:lang="en">Clinical risks and surgical results of patients with arteriovenous malformations / J. Zhao [et al.] // Surg neurol. – 2005. – Vol. 63. – P. 156 – 61.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
