外伤性颈内动脉海绵窦瘘的介入治疗(附60例报告)

Interventional endovascular treatment of carotid cavernous fistulas (report of 60 Cases)

目的分析６０例外伤性颈内动脉海绵窦瘘用血管内栓塞治疗的方法、结果和技术特点。方法４７例用可脱球囊栓塞；１２例用弹簧圈栓塞；１例用ＩＢＣＡ胶栓塞。５９例经股动脉穿刺插管至颈内动脉进入海绵窦，１例经扩张的眼上静脉插管至海绵窦内。结果①４７例球囊栓塞中，３５例保持了颈内动脉通畅，占７４．５％；１２例闭塞了颈内动脉。②１２例弹簧圈栓塞中，４例保持了颈内动脉通畅，占３３％；８例闭塞了颈内动脉。③１例经眼上静脉插管用ＩＢＣＡ胶栓塞成功。结论介入放射血管内栓塞治疗颈内动脉海绵窦瘘其方法简便、安全可靠、效果良好，特别是用可脱球囊栓塞，保持颈内动脉通畅率高。

? Objective The paper sought to analyse th e method, result and technical characteristics of endovascular embolization in t he process of treating 60 patients with carotid cavernous fistulas (CCF). Methods 47 patients were embolised with detachable ba lloon, 12 with coil, 1 with IBCA. Catheterizations were performed in 59 patients via. the femoral artery, and in 1 by way of dilated superior ophthalmic vein (S OV). Results 47 patients undergone emdolization with balloon, the c arotid arteries remained patent in 35 patients (74%) and were occluded in 12 pat ients (24%) after embolization. Of the 12 cases embolised with coil, the patency of carotid arteries were achieved in 4 patients (33%), and were occluded in 8. Embolization with IBCA was succeeded in 1 patient by route of SOV. Conclusions Interventional endovascular therapy is a convenient, sa fe and effective way for the treatment of CCF. Additionally the higher rate of p atency of the carotid artery can be attained when detachable balloon is adopted as embolic material.  【