外伤性颈内动脉海绵窦瘘球囊栓塞治疗

目的:探讨治疗外伤性颈内动脉海绵窦瘘的治疗方法。方法:对一组外伤性颈内动脉海绵窦瘘(CCF)的病人采用可脱性球囊栓塞治疗。结果:该组6例病人均获治愈。疗效满意。结论:可脱性球囊栓塞是治疗外伤性颈内动脉海绵窦瘘的首选方法。     

外伤性颈内动脉海绵窦瘘治疗

外伤性颈内动脉海绵窦瘘（Carotid Cavernous Fistual．CCF）是指海绵窦内的颈内动脉或及其分支因外伤破裂直接与静脉交通形成动静脉瘘．致使全部脑血循环的血液动力学发生变化。影响的轻重取决于CCF的分流量和海绵窦内的压力。笔者白1995年1月至2005年1月，共收治此类病人15例，报告如下。     

外伤性颈动脉海绵窦瘘的血管内栓塞治疗

目的 比较不同方法治疗外伤性颈动脉海绵窦瘘的临床效果。方法 治疗中应用球囊导管,复杂的5例使用了胶及弹簧圈等栓塞材料。结果 10例成功闭塞瘘口且保留载瘤动脉通畅,2例闭塞载瘤动脉．结论 外伤性颈动脉海绵窦瘘应首选血管内栓塞治疗。有时瘘口太小,弹簧圈也是有效方法。     

可解脱弹簧圈结合游离纤毛铂金弹簧圈栓塞治疗外伤性颈内动脉海绵窦瘘

<正>外伤性颈动脉海绵窦瘘是介入神经外科血管内治疗效果较好的一种疾病,手术操作简单,治愈率高,并发症少[1]。1972年Serbinenko首先报道用可脱球囊治疗TCCF,目前这一治疗方法被认为是TCCF的首选治疗方法。该方法对于瘘口偏小,海绵窦内骨碎片刺破球囊等情况较难处理,需改用可解脱弹簧圈栓塞,该法栓塞效果好但费用高,特别是在经济还不发达,生活水平不高的地区,许多患者及家庭无法承受。     

外伤性颈内动脉海绵窦瘘的多普勒超声诊断与监测

自1999年10月至2002年10月,本院采用彩色多普勒成像技术(ColorDopplerimaging,CDI)和经颅多普勒超产血流显像(transcranialcolorDopplerimaging,TCDI),对11例外伤性颈内动脉海绵窦瘘(Traumaticcarotidcavernousfistulae,TCCF)进行分析及栓塞治疗后的随访监测。全部病例与数字减影脑血管造影(DSA)结果完全符合,报告如下。1资料与方法1.1一般资料:本组11例,男7例,女4例;年龄11～61岁,平均32岁。均为外伤后发病,其中车祸伤8例,坠落伤2例,锐器刺伤1例。临床表现:全部病人均有眼部血管性杂音,9例出现搏动性突眼、球结膜水肿和充血、眼球…     

介入栓塞治疗外伤性左颈内动脉海绵窦瘘伴假性动脉瘤1例

外伤性颈内动脉-海绵窦瘘(TCCF)比较少见,而同时伴有蝶窦内假性动脉瘤者,常因难以控制的鼻衄死亡.国内有散在病例报告[1,2,3].2001年6月笔者对1例外伤性左颈内动脉海绵窦瘘伴假性动脉瘤导致失血性休克的患者行介入栓塞治疗,取得满意疗效.现总结报告如下.     

外伤性颈动脉海绵窦瘘（TCCF）的血管内治疗

目的：总结外伤性颈动脉海绵窦瘘（TCCF）治疗方法的选择、栓塞技术及疗效。方法：TCCF检塞治疗26例患者，经动脉入路25例，经静脉入路1例；用可脱性球囊检塞瘘口21例，行颈内动脉球囊闭塞术3例，用微弹簧圈检塞治疗2例。结果；24例患者一次性检塞成功，2例检塞后因球囊早泄复发，再次经球囊检塞后治愈。一次性检塞治愈率92.3%，颈内动脉畅通率88.5%(23/26)。随访2-12个月，有2例并发假性动脉瘤形成，1例症状明显行GDC检塞治疗后治愈，另1例无症状继续随访，本组无死亡及其他并发症。结论：经动脉入路用可脱性球囊检塞瘘口是治疗TCCF的首选方法：对于球囊无法进入的小瘘口TCCF可选 用微弹簧圈检塞；若动脉入路不能或失败可行静脉入路检塞瘘口；对于瘘口在放置多个球囊仍不能将瘘口检塞的患者，可考虑闭塞颈内动脉。     

外伤性颈动脉海绵窦瘘二例

颈动脉海绵窦瘘（carotid-cavernous fistula,CCF）是一种少见的以眼部症状为突出表现的颅内血管疾病,多因外伤引起,称为外伤性颈动脉海绵窦瘘（traumatic carotid cavernous fistula,TCCF）。TCCF的发病率近年随车祸及其他外伤的增多呈上升趋势。现报道2例。     

Traumatic superior mesenteric artery—Portal vein fistula

An interesting and rare case of traumatic superior mesenteric artery-to-portal vein arteriovenous fistula is presented. Initial operative control of the bleeding superior mesenteric artery injury required ligation of the superior mesenteric artery at its origin to prevent exsanguination in an extremely unstable patient with multiple injuries. Early postoperative visceral arteriography documented ligation of the superior mesenteric artery with a proximal superior mesenteric artery-to-portal vein arteriovenous fistula. Percutaneous catheter embolization of the arteriovenous fistula was undertaken successfully at this time. Superior mesenteric artery ligation was surprisingly well tolerated. Major arterioportal fistulas require treatment to prevent long-term complications of intestinal ischemia, portal hypertension, and cirrhosis. Although traditional treatment involves ligation of the arteriovenous fistula and arterial bypass, percutaneous embolization is becoming a viable alternative. Arteriography remains the cornerstone of diagnosis and treatment planning.     

Embolization for traumatic carotid cavernous sinus fistula using platinum coil]

We treated a patient with a traumatic carotid-cavernous fistula (CCF) by embolization using a Tracker catheter and platinum coils by transarterial and transvenous approaches. A 65-year-old female sustained an injury in the right frontal region of the head in April, 1989. After 1 month, she was admitted to our hospital due to exophthalmos, congestion of the palpebral conjunctiva, ptosis, and a bruise in the right frontal region of the head. Right carotid angiography showed a CCF between the anterior ascending segment and the horizontal segment that drains into the superior ophthalmic vein, superior petrosal sinus and inferior petrosal sinus. To occlude the fistula, embolization was performed twice using platinum coils. In the first embolization, the cavernous sinus was approached transarterially and transvenously using a Tracker catheter system, and a total of 7 platinum coils were used for the embolization. The bruise disappeared immediately after embolization but recurred 3 days after the operation. Angiography demonstrated re-communication of the CCF. The second embolization was initially performed using a detachable balloon, but the balloon could not be passed through the fistula. Therefore, a Tracker catheter was advanced to the fistula transarterially and embolization was performed using 3 platinum coils. The fistula was occluded. Follow-up angiography after 1 year in August, 1990 showed complete occlusion of the fistula. The detachable balloon system was recently introduced in neurological and radiological departments, as a new surgical method for CCF. At present, this method is the first choice for CCF. However, the detachable balloon system presents some technical problems.(ABSTRACT TRUNCATED AT 250 WORDS)     

Endovascular repair of traumatic superior mesenteric artery to splenic vein fistula

Traumatic mesenteric arterioportal fistulas (APF) are rare but serious and life-threatening. This article reports the case of a 24-year-old female who suffered a gunshot wound to the abdomen and subsequently developed a superior mesenteric artery (SMA) pseudoaneurysm and APF, which caused secondary right heart failure and pulmonary hypertension. The patient underwent a successful endovascular stent-graft exclusion of the pseudoaneurysm/APF. The patient was asymptomatic 18 months post procedure and leading an active life with a normal arterial flow in the SMA confirmed by duplex ultrasonography.     

经上睑静脉途径给药治疗海绵窦血栓性静脉炎

目的 探索治疗海绵窦血栓性静脉炎的新途径。方法 用经上睑静脉途径给药方法治疗海绵窦血栓性静脉炎15例。结果 本组无死亡病例，治愈12例，治愈率为80％，好转3例，遗留后遗症3例，病残率为20％。结论 经上睑静脉途径给药治疗海绵窦血栓性静脉炎提高了治愈率，减少了死亡率和病残率，方法简单易行。     

Portal vein thrombosis after laparoscopic colectomy: thrombolytic therapy via the superior mesenteric vein

Portal vein thrombosis is a rare but well-reported complication after laparoscopic surgery. We present a case of portomesenteric venous thrombosis that occurred 8 days after a laparoscopic-assisted right hemicolectomy. Systemic anticoagulation failed to improve symptoms. The early postoperative state precluded the use of transarterial thrombolytic therapy. Transjugular intrahepatic catheter-directed infusion of urokinase into the superior mesenteric vein resulted in clearance of thrombus and resolution of symptoms. The published data on laparoscopy-induced splanchnic venous thrombosis and transjugular intrahepatic intramesenteric thrombolysis are discussed.     

Subepicardial aneurysm by venting catheter via the right superior pulmonary vein

Subepicardial aneurysm caused by a left ventricular venting catheter inserted from the right superior pulmonary vein is very rare. Generally, this type of aneurysm is a complication of acute myocardial infarction. We report a 76-year-old woman in whom a left ventricular aneurysm was shown by transthoracic echocardiography 3 years after mitral valve replacement. She underwent left ventricular aneurysmectomy via the 4^th left intercostal space. The left ventricular aneurysm was separated from the pericardium completely; therefore, this aneurysm was not thought to be pseudoaneurysm. The postoperative course was uneventful and the aneurysm was diagnosed as a subepicardial aneurysm from a histological examination.