微弹簧圈栓塞术治疗外伤性颈内动脉海绵窦瘘的临床研究

The treatment of traumatic carotid-cavernous fistula by the intravascular embolization with guglielmi detachable coil

目的探讨微弹簧圈栓塞术治疗外伤性颈内动脉海绵窦瘘(TCCF)的临床效果。方法回顾性分析15例(15只眼)TCCF病例,采用计算机体层摄影术(CT)、核磁共振成像(MRI)和数字减影血管造影(DSA)明确诊断,应用微弹簧圈栓塞术进行治疗。对术前和术后眼部改变进行评价。结果术前所有病例均有程度不同的眼球突出,13只眼(86.7%)有眼外肌麻痹,11只眼(73.3%)出现视乳头充血,14只眼(93.3%)出现高眼压,11只眼(73.7%)有不同程度的视力下降。15例(15只眼)全部1次栓塞治疗成功,无并发症发生。所有患眼病情得到明显缓解,视力均在0.5以上。结论微弹簧圈栓塞术是一种治疗TCCF安全、有效的方法。

Objective To investigate the clinical effect of the treatment of traumatic carotid-cavernous fistula（TCCF） by the intravascular embolization with Guglielmi detachable coil（GDC）. Methods In this retrospective case series, intravascular treatment with GDC were applied to treat 15 patients. Their diagnosis were made according to computerized tomography（ CT） , nuclear magnetic resonance imaging（MRI） and digital subtraction angiography（ DSA）. Preoperative and postoperative changes of injured eyes were appraised. Results Among all preoperative eyes,there are 15 pulsating exophthalmos （ 100% ）, 13 extraocular palsies （ 86.7% ）, 11 hyperemia of papilla optica （ 73.3%） , 14 ocular hypertension （ 93. 3%） and 11 impaired vision with different levels（73.3% ）. All cases had recovered better without serious complications after first operation. The state of ill eyes had relieved or eliminated obviously. All of eyes obtained better corrected visual acuity （ ≥0.5）. Conclusion Intravascular embelization with GDC is a safe and effective clinical treatment of TCCF.