血管内栓塞治疗颈内动脉海绵窦瘘

目的　探讨颈内动脉海绵窦瘘 (CCF)血管内栓塞治疗的效果。方法　 5例均经DSA全脑血管造影明确瘘口部位 ,采用可脱性球囊或电致血凝性可脱性铂金弹簧圈 (GDC)进行栓塞。结果　 5例中 ,1例球囊栓塞成功并保持颈内动脉通畅 ;2例表现为假性动脉瘤 ,用球囊闭塞患侧颈内动脉 ;1例因瘘口太小 ,用GDC填塞海绵窦 ;另 1例 2次试放球囊入海绵窦均破裂失败 ,其中 1枚瘪陷球囊滞留于海绵窦 ,患者不愿闭塞患侧颈内动脉未予进一步治疗 ,但患者治疗术后 1周临床症状和体征消失。结论　颈内动脉海绵窦瘘全脑血管造影可明确瘘口部位、大小 ,首选治疗方法是血管内栓塞治疗。

The Treatment of Carotid -cavernous Fistulae with Intravascular Embolization

Objective To investigate the therapeutic effect of intravascular embolization of carotid-cavernous fistulation.Methods 5 cases were examined by DSA of brain to find out the sites of fistulation.The detachable balloon or GDC(Guglielmi Detachable Coil)were employed in embolotherapy.Results 1 cases were embolized successful with detachable balloon and kept free circulation of ICASs;The embolism of ICA involved side were performed in 2 cases for patient with pseudoaneurysm and 1 patients cavernous involved were embolized with GDC for small mouth of the fistula.Another case balloon raptured two times when it was detached to cavernous after one free balloon was dept in cavernous,the patient didn't want to embolized the ICA involved,the trentment was stoped,the patients symptoms was disappeated after one week of therapy.Conclusion The site and size of carotic-cavernous fistulation can be detected by DSA of brain intravascular embolization is the first-choise method of therapy for it.