外伤性颈动脉海绵窦瘘血管内治疗探讨

目的 探讨对外伤性颈动脉海绵窦瘘(TCCFs)的血管内治疗方法。方法 240例TCCFs病人，其中214例采用可脱性球囊栓塞，23例采用弹簧圈栓塞(5例经股静脉→岩上窦人海绵窦内栓塞)，3例经眼上静脉人海绵窦内栓塞(2例采用微弹簧圈栓塞，1例采用NBCA胶栓塞)。结果 214例采用可脱性球囊栓塞，198例保持颈内动脉通畅，通畅率92．5％，随访，除1例在半年后复查发现原瘘口处假性动脉瘤外(因无症状，未处理)，其余痊愈516例行颈内动脉闭塞，其中3例分别在1—2个月发现颈外动脉分支与海绵窦相通，经真丝线段，NBCA栓塞而愈。其余26例全部治愈。结论 大多数TCCFs病人可通过可脱性球囊和弹簧由血管内栓塞而治愈，但可脱性球囊应首选。

Exploring Endovascular Treatment of Traumatic Carotid Cavernous Fistulas

Objective To explore the endovascular treatment of traumatic carotid cavernous fistulas(TCCFs).Methods Of240cases with TCCFs,214were transaterially embolized by the detachable balloons,18trasanterially by the coils,5intracavernously through the femoral vein and superior petrous vein by the coils and3tracavernously through the ophthalmic vein by the coils(2cases)and NBCA(1cases).Results Of214cases of TCCFs embolized by the detachable balloons,198(92.5%)had unobstructed the internal carotids and16received occluding the internal carotids.The follow-up for6months showed that of198cases with unobstructed the internal carotids,1suffered asymptomatic false aneurysm(not treated)in the fistula mouth and197were fully recovered;The some branches of the external carotid and cavernous sinuses were communicated with each other in3of16cases with the occluded internal carotids(all were cured by endovascular reembolization with silk suture and NBCA).All the26cases with TCCFs embolized by the coils and NBCA were cured.Conclusion The most patients with TCCFs can be cured by endovascular embolization with the detachable balloons and coils,but detachable balloons should first be selected for treating TCCFs.