经面静脉-眼静脉途径栓塞海绵窦区硬脑膜动静脉瘘

目的探讨经面静脉-眼静脉途径栓塞治疗海绵窦区硬脑膜动静脉瘘（CSDAVFs）的方法和疗效。方法自2001年4月至2005年9月采用经股静脉-面静脉-眼静脉途径插管，以弹簧圈栓塞治疗CSDAVFs病人9例。结果7例病人导管均成功插入海绵窦，其中6例病人栓塞后完全治愈，另1例病人不全栓塞，但病人突眼、球结膜充血等症状完全好转。1例病人由于术中眼静脉痉挛导致插管失败，术后症状加重，但2个月后眼部症状完全恢复正常。1例病人由于插管失败，改行眼静脉切开穿刺插管成功栓塞。随访4～51个月，9例病人均未复发。结论对于岩下窦插管困难、面静脉和眼静脉扩张明显而无明显迂曲的CSDAVFs病人采取经面静脉-眼静脉栓塞治疗,其疗效较满意。

Embolization of Cavernous Sinus Dural Arteriovenous Fistulas through Facial and Superior Ophthalmic Veins

Objective To explore the method and effect of transvenous embolization of cavernous sinus dural arteriovenous fistulas (CSDAVFs) through the facial vein (FV) and superior ophthalmic vein (SOV). Method Nine patients with CSDAVFs were treated by embolization through the FV and SOV approach with platinum coils. Results The CSDAVFs were successfully embolizated in 7 patients, of whom, 6 received total embolization of CSDAVFs and were cured, and 1 received subtotal embolization of CSDAVFs and was significantly improved in the symptoms. The microcatheter was not inserted into the FV and SOV, and the CSDAVFs were not embolizated due to vasospasm in 1 case, but the symptoms in the eye disappeared 2 months later. The CSDAVFs was totally embolizated after SOV was exposed by surgery and was punctured. The following-up from 4 to 51 months showed that CSDAVFs did not recur in all the patients. Conclusion The embolization of CSDAVFs through FV and SOV can be performed safely and effectively in some patients.