可脱性球囊栓塞治疗外伤性颈内动脉-海绵窦瘘

目的:报告采用可脱性球囊栓塞治疗外伤性颈内动脉-海绵窦瘘(TCCF)10例,取得较为满意的效果.方法:经股动脉插管采用Magic 3F/1.8F可脱性球囊导管,用国产乳胶球囊闭塞瘘口,球囊充填剂为等渗的Ominipaque.结果:本组10例中1次栓塞成功7例,2次栓塞成功1例,1例部分栓塞,1例失败,治愈率为80%,6例颈内动脉保持通畅,1例术后球囊移位,3例出现脑血管痉挛.结论:可脱性球囊栓塞治疗TCCF是目前较为理想的治疗方法,但术中要尽量闭塞瘘口,保持颈内动脉通畅,并注意球囊移位及脑血管痉挛的发生.

Traumatic carotid-cavernous fistula treatment by detachable balloon embolization

Traumatic internal carotid-cavernous fistula (TCCF) is a difficult problem in clinical practice. Presently, the recent development of en-dovascular neurosurgery has provided a new method in the treatment of TCCF. The authors treated 10 cases of TCCF by detachable balloon embolization. The results were satisfactory. Method;The detachable balloon catheter (Magic 3F/1. 8F) was inserted via the femoral artery. The fistula was embolized by domestic made latex balloon. The balloon was inflated with onani-paque. Result; 7 cases were successfully embolized in one time, 1 case in two times. 1 case was partially embolized and 1 case failed. The rate of cure was 80 % . In 6 cases the patency of internal carotid arteries were preserved. The balloon was displaced from the initial location after operation in one case. Cerebral vasospasm were happened in 3 cases. Conclusion: The detachableballoon embolization is so far the ideal method for treatment of TCCF. The fistula should be completely embolized and the patency of the internal carotid antery should be preserved. Attempt should be made to prevent the displacement of balloon and cerebral vasospasm.