血管内栓塞治疗外伤性颈内动脉海绵窦瘘7例

探讨颈内动脉海绵窦瘘(CCF)血管内栓塞治疗的效果.方法:7例均经DSA全脑血管造影明确瘘口部位,采用可脱性球囊或电致血凝性可脱性铂金弹簧圈(GDC)进行栓塞.结果:7例中,3例球囊栓塞成功并保持颈内动脉通畅;2例表现为假性动脉瘤,用球囊闭塞患侧颈内动脉;1例因瘘口太小,用GDC填塞海绵窦;另1例两次试放球囊入海绵窦均破裂失败,其中一枚瘪陷球囊滞留于海绵窦,患者不愿闭塞患侧颈内动脉未予进一步治疗,但术后一周临床症状和体征均消失.结论:颈内动脉海绵窦瘘全脑血管造影可明确瘘口部位、大小,首选治疗方法是血管内栓塞治疗.

Treatment of carotid-cavernous fistula with intravascular embolization

Objective:To investigate the therapeutic effect of intravascular embolization on carotid cavernous fistula.Methods:Seven cases were examined by digital substraction angiography(DSA) of the global brain,so as to find out the sites of the fistula.The detachable balloon or guglielmi detachable coil(GDC) were employed in embolotherapy.Results:Three cases was embolized successfully with detachable balloon and kept free circulation of ICASs.The embolism of ICA involving the side was performed on 2 cases with pseudoaneurysm and 1 patient's cavernons was embolized with GDC for small mouth of the fistula.For another case,balloon ruptured two times when it was detached to the cavernons.After one free balloon was kept in the cavernons,the patient didn't want to have the ICA involved embolized.The treatment was stopped,but the patient's symptoms and signs disappeard one week after therapy.Conclusions:DSA of brain vessels can depict the site,and size of carotid cavernous fistula.Intravascular embolization is the choice of therapy.