外伤性颈动脉海绵窦瘘血管内治疗及随访

目的探讨外伤性颈动脉海绵窦瘘（TCCF）血管内治疗的方法及长期疗效。方法本组528例,经动脉途径血管内治疗503例．其中放风筝法4例,弹簧圈栓塞13例,可脱性球囊栓塞430例,球囊与微弹簧圈栓塞32例,微弹簧圈栓塞24例;经静脉途径血管内治疗25例,其中经眼静脉微弹簧圈栓塞12例,NBCA胶栓塞1例,经股静脉一岩上窦、微弹簧圈栓塞12例。255例随访1～15年。结果528例全部治愈,主要并发症包括暂时脑缺血4例,假性动脉瘤2例。5例栓塞后1～2个月TCCFs复发,经用NBCA胶和丝线再栓塞而愈。结论TCCF病人首选血管内治疗,血管内治疗首选可脱性球囊。

Endovscular Treatment and Following-up of Traumatic Carotid Cavernous Fistulas

Objective To explore the long-term curative effect of endovscular treatment on traumatic carotid cavernous fistulas (TCCFs). Methods Of 528 patients with TCCFs,503 were treated by transarterial embolization including "flying kite" technique (4 cases),coils (13 cases),detachable balloons (430 cases),microcoils (24 cases) and detachable balloon combined with microcoils (32 cases) embolization,and 25 by transvenous embolization including embolization through ophthalmic veins with by microcoils (12 cases),and NBCA (1 case),and through femoral venous-superior petrosal sinus with microcoils (2 cases). Two hundred and fifty-five patients were followed up from 1 to 15 years. Results All the patients were cured. Temporary cerebral ischemia occurred in 4 patients and pseudoaneurysm in 2 patient. TCCFs recurring in 5 patients from 1 to 2 months after the embolization were cured by reembolization with NBCA and silk suture. Conclusions Endovascular embolization is the optimal method to treat TCCFs. The detachable balloon is preferable to the other embolic material.