外伤性颈动脉海绵窦瘘合并假性动脉瘤的血管内介入治疗

目的 探讨外伤性颈动脉海绵窦瘘（TCCF）合并假性动脉瘤的临床特点及血管内介入治疗方法及疗效。方法 回顾性分析武汉大学人民医院神经外科2012年1月至2015年12月收治的10例TCCF合并假性动脉瘤的临床资料。10例均行血管内介入治疗，其中5例单纯应用血管内可脱球囊治疗，2例联合应用球囊及弹簧圈栓塞治疗，1例行球囊辅助Onyx胶联合弹簧圈栓塞治疗，2例行患侧颈内动脉闭塞术。结果 术后无死亡病例。10例术后DSA证实海绵窦瘘及假性动脉瘤均未显影，未闭塞患侧颈内动脉的8例患侧颈内动脉无分支动脉损伤，保持通畅。术后随访6个月至2年，无再发鼻衄及神经功能障碍。结论 对于TCCF合并假性动脉瘤，血管内介入治疗是理想的治疗方法，首选单纯应用血管内可脱球囊治疗，可脱球囊联合其他栓塞材料或单独使用其他栓塞材料是有效的补充。

Endovascular treatment of traumatic carotid cavernous fistula associated with pseudoaneurysms

Objective To explore the clinical features and technique of endovascular treatment of traumatic carotid cavernous fistula (TCCF) associated with pseudoaneurysms. Methods The clinical data of 10 patients with TCCF associated with pseudoaneurysms, who were treated in Department of Neurosurgery of Renmin Hospital of Wuhan University from January, 2012 to December, 2015, were analyzed retrospectively. Of 10 patients, 5 received endovascular embolization only with detectable balloon, 2 with detectable balloon combined with coils, 1 with detectable balloon combined with coils and Onxy glue and 2 received internal carotid artery occlusion in the involved sides. Results No patients died of the operation. The successful occlusions of the TCCF and pseudoaneurysms were achieved in all the patients. The internal carotid arteries were free and no arterial branches were injured in 8 patients. The following-up from 6 months to 12 years showed that there were no epistaxis and neurological dysfunctions in all the patients. Conclusions Endovascular embolization is an ideal method to treat TCCF associated with pseudoaneurysms. The detachable balloon is preferable to the other materials, which is an effective supplement for the endovascular embolization of TCCF associated with pseudoaneurysms.