颈动脉-海绵窦瘘的诊断和栓塞治疗

Diagnosis and endovascular embolization of carotid cavenous fistulae

目的：本文报告７６例颈动脉－海绵窦瘘及其栓塞治疗。方法：本组均经股动脉和患侧颈动脉入路，选用可脱球囊、微螺旋圈和聚乙烯醇颗粒进行栓塞处理。结果：７５例栓塞成功，仅１例栓塞后有部分瘘口未完全闭合；５８例（８３％）颈内动脉得以保留。结论：本组体会，颈动脉海绵窦瘘有颈内外动脉复合型、颈内动脉型和颈外动脉型；依不同的类型选用不同的材料和方法栓塞，可提高治疗效果。

Objective:The endovascular embolization of 76 cases of posttraumatic or spontaneous carotid cavemous fistulae (CCF) were repored.Methods:The CCF was embolized via femoral artery incubation in 69 cases, common carotid artery in 5 cases, and the superior ophthalmic vein (SOV) in 2 cases. The detachable balloon, micro coils, and PVA particles were selected as embolizing materials. Results:Satisfactory results wre achieved in 75 cases (98.7%). Only in one case, the fistula was not completely occluded after embolization. The fistula was embolized with preservation of the internal carotid artery (ICA) in 58 cases (83%). Conclusion:The results show that CCF can be devided into three types: ICAcavernous type, external carotid artery (ECA)cavernous type, and mixed type. It is important to select different materials for different types of CCF to improve the embolizing effects. The methods of preserving the ICA were also discussed.