颈动脉海绵窦瘘的血管内治疗

目的 总结199例颈动脉海绵窦的血管内治疗。方法 根据Barrow的分类，A型147例，B型3例，C型12例，D型37例。A型主要利用动脉途径可脱球囊栓塞，对B，C，D型主要经静脉途径用弹簧圈栓塞。结果 治愈率为94，5％，颈内动脉通畅率为96．5％，偏瘫占3.5％，病死率为0.5％。结论 A型瘘的治疗首选动脉途径用可脱球囊栓塞，对于动脉途径球囊栓塞有困难、有危险的A型瘘和B，C，D型瘘可采用静脉途径用球囊或弹簧圈栓塞，不必牺牲颈动脉的通畅。

Endovascular treatment of carotid cavernous sinus fistulas

Objective To study the endovascular treatment for 199 carotid cavevnous sinus fistulas (CCF) Methods According to Barrow's CCF classification,the number of type A was 147 cases and the number of type B,C and D were 52 cases Majority of type A were treated by arterial approach using the detachable balloons Some complicated type A cases and most of B,C,D cases were treated by venous approach using the tungsten coils or balloons. Results Of the 199 cases,94.5% were cured. Internal carotid artery patency rate was 96,5%. 3 5% suffered from postoperative hemiplegia. Mortality rate was 0 5%.Conclusion Detachable balloon technique is the optimal treatment for type A The venous approach and coiling the cavernous sinus is better for type B,C and D,and also suitable for some complicated type A cases without deliberately occluding internal carotid artery