创伤性颈内动脉海绵窦瘘的介入治疗

目的:探讨不同类型的创伤性颈内动脉海绵窦瘘的介入治疗方法。材料和方法:回顾性分析63例经全脑数字减影血管造影(DSA)诊断的创伤性颈内动脉海绵窦瘘的治疗方法:血管内栓塞、栓塞结合手术孤立瘘口或瘘口所在的颈内动脉内覆膜支架置入等方式。结果:63例创伤性颈动脉海绵窦瘘中,术后59例动静脉瘘完全闭塞,4例大部分闭塞;临床症状消失62例,好转1例。本组无并发症发生。结论:创伤性颈内动脉海绵窦瘘治疗的关键在于闭塞瘘口。根据其动静脉瘘的部位、供血动脉及瘘口的数量、引流静脉的特点等综合考虑栓塞材料的选择是保证治疗成功的重要因素。

Interventional Treatment for Traumatic Carotid-cavernous Fistulas

Purpose: To discuss the methods of treatment for different types of traumatic carotid-cavernous fistulas(TCCF).Materials and Methods: The methods of treatment in 63 cases that were diagnosed by digital subtraction angiogrophy(DSA) were analyzed retrospectively.The methods included endovascular embolization,embolization and isolating the fistula by surgical operation or implantation of covered stent.Results: After operation among the 63 cases the fistulas were completely occluded in 59 cases,and mostly occluded in 4 cases;the clinical symptoms were disappeared in 62 cases,improved in 1 case.No complication occurred in this group.Conclusions: The key to treat traumatic carotid-cavernous fistulas is to occlude the fistula.The choice of embolic materials for successful treatment is an very important factor,and it should be considered on the basis of the place of fistulas,the amount of feeding arteries,the amount of entrance of fistulas and the characteristic of the draining vein.