动脉瘤性颈内动脉海绵窦瘘的血管内治疗

Endovascular treatment of aneurysmal carotid-cavernous fistulas

目的总结应用血管内技术治疗颈内动脉海绵窦段动脉瘤破裂导致颈内动脉海绵窦瘘(CCF)的经验体会。方法回顾性分析8例颈内动脉海绵窦段动脉瘤破裂致CCF患者的临床资料以及应用的血管内技术,其中单纯应用可脱球囊治疗1例,弹簧圈结合可脱球囊进行治疗2例,球囊辅助弹簧圈栓塞治疗2例,覆膜支架治疗1例。结果8例患者中6例治疗成功,无技术相关性并发症;1例治疗前突然死亡;1例放弃治疗。结论血管内技术是治疗颈内动脉海绵窦段动脉瘤破裂致CCF的安全、有效方法。

Objective To summarize the experience of endovascular treatment of carotid cavernous fistula （CCF） caused by ruptured cavernous sinus aneurysm. Methods A retrospective review of 8 patients with ruptured cavernous sinus aneurysm causing carotid cavernous fistula （CCF） in whom endovascular treatment was used between May 2003 and June 2007. Detachable balloon was used as the embolic material in 1 patient, detachable balloon and detachable coil as the embolic material in another 2 patients, balloon assisted coil embolization in 2 patients, covered stents were successfully placed in the parent vessel to exclude the aneurysm and fistula from circulation in the last patient. Results All 6 patients were successfully treated by means of transarterial embolization, and no technique related complications, one patient gave up and another patient died shortly before scheduled treatment. Conclusion In our practice, endovascular treatment seemed to be a safe and effective method for CCF caused by ruptured cavernous sinus aneurysm.