外伤性颈内动脉海绵窦瘘血管内个体化治疗145例疗效分析

目的：分析外伤性颈内动脉海绵窦瘘几种常见的血管内治疗方法，探讨其最安全有效的个性化治疗方案。方法：对145例外伤性颈内动脉海绵窦瘘进行回顾性分析，其中103例行可脱性球囊栓塞，5例行可脱落球囊结合弹簧圈栓塞，4例行可脱性球囊结合Onyx胶栓塞，1例行可脱性球囊结合覆膜支架栓塞，10例行弹簧圈栓塞，4例行弹簧圈结合Onyx胶栓塞，6例行Onyx胶栓塞，4例行覆膜支架置入，8例行颈内动脉闭塞。对各种治疗方法及结果进行总结和分析。结果：颈内动脉保持通畅137例（94．5％），眼部并发症1例（0．7％），颈内动脉狭窄1例（0．7％），神经系统并发症2例（1．4％），无相关手术死亡病例，随访3个月-3年，复发5例（3．4％）。结论：个体化的介入方案是治疗外伤性颈内动脉海绵窦瘘的理想方法，可脱性球囊是首选，可脱性球囊结合其他栓塞材料及单独使用其他栓塞材料是有效的补充，闭塞颈内动脉应是最后的选择。

Analysis on treatments with traumatic carotid-cavernous fistula artery in 145 cases

Objective： To analyze treatments with traumatic carotid-cavernous fistula and to find out an effective method. Method： One hundred and forty five traumatic carotid-cavernous fistula patients were retrospectively reviewed in our department, among which 103 were conducted with detachable balloon occlusion, 5 with detachable balloon and coil embolization, 4 with detachable balloon and Onyx glue embolization, 1 with detachable balloon with covered stent embolization, 10 with coil embolization, 4 with coil with Onyx glue embolization, 6 with Onyx glue embolization, 4 with covered stent, 8 with interaliwe carotid artery occlusion. Results： Effects were analyzed and we found out that in 137 cases the internal carotid weres smooth, accounting for 94.5% of all cases; 1 with eye complication（0. 7% ） ; 1 with internal carotid stenosis（0. 7% ）, 2 with neurological complications（ 1.4% ）. There was no case of death. 5 cases recurred during a follow-up of 3 months to 3 years. Conclusion： Individulized inter- vention is anideal method for traumatic carotid-cavernous fistula. The detachable balloon is most preferable, and is an effective supplement in otherkind of embolization Internal carotid occlusion should never be the first choice.