微弹簧圈栓塞难治性外伤性颈动脉海绵窦瘘的临床研究

目的　探讨和研究用微弹簧圈血管内栓塞部分难治性外伤性颈动脉海绵窦瘘。方法　回顾 2 4例用微弹簧圈或结合其它栓塞材料栓塞治疗的难治性外伤性颈动脉海绵窦瘘 ,18例经动脉入路用微弹簧圈栓塞治疗 ,3例经岩下窦入路 ,另 3例经眼静脉入路。 7例首次用弹簧圈栓塞 ,另 17例弹簧圈结合球囊、NBCA(α -氰基丙烯酸正丁酯 )等栓塞材料栓塞。结果　栓塞术后血管造影结果示 ,7例较前改善 ,17例达到治愈。临床结果 :2 1例(87.5 % )治愈 ,3例 (12 .5 % )明显改善 ,无恶化者。随访时间为 6 - 2 4个月临床均达治愈 ,无复发。结论　球囊栓塞困难的小瘘口型外伤性颈动脉海绵窦瘘可选用微弹簧圈栓塞 ,其疗效可靠且安全。对复发或多次治疗后形成的复杂难治性外伤性颈动脉海绵窦瘘也可选用弹簧圈或结合其它栓塞材料联合治疗

Endovascular therapy of the intractable traumatic carotid cavernous fistulae:clinical study

Objectives To study and question the endovascular embolization of refractory traumatic carotid cavernous fistulae(TCCF) with microcoils.Methods To retrospect twenty-four patients embolized of intractable TCCF with microcoils or combination with other materials.Results Eighteen patients were treated by transarterial approach with microcoils, and 6 by transvenous embolization via the inferior petrosal sinus(IPS) pathway or the superior ophthalmic vein(SOV).Seven patients were first treated with microcoils alone, and 17 with microcoils or combination with other materials.The angiographic results shows 17 patients cured, and 7 improved. But the clinical results shows 21 patients cured, and 3 improved, no worsen.Follow-up time was 6-24 months. Conclusions TCCF of small hole embolized difficulty with balloons can be embolized with microcoils, and it is reliable and security. The complex intractable TCCF treated many times or recurred may be embolized with microcoils or combination with other materials.