可脱性球囊栓塞治疗外伤性颈内动脉海绵窦瘘

Embolization Treatment with Detachable Balloon for Traumatic Carotid Cavernous Fistulas

目的 探讨外伤性颈内动脉海绵窦瘘 (TCCF)的神经血管内介入治疗技术。材料与方法 应用法国Balt公司的同轴可脱性球囊技术 ,在数字减影 (DSA)监视下 ,对 12例TCCF患者施行可脱性球囊栓塞治疗。结果 9例患者成功地用球囊闭塞了颈内动脉瘘口 ,同时也保持了颈内动脉通畅 ;2例由于球囊进入瘘口困难 ,1例CCF瘘口较大 ,改行闭塞瘘口同时闭塞了颈内动脉。术后除 1例失明未恢复外 ,其余病例临床症状完全消失。结论 可脱性球囊血管内栓塞技术是目前治疗TCCF的最好方法 ,其具有损伤小。

Objective To explore endovascular treatment technique for traumatic carotid cavernous fistulas (TCCF).Materials and Methods Twelve cases of TCCF were treated with co axial detachable balloon catheter (Balt Company, France) under DSA monitoring.Results TCCF was successfully embolized with carotid remaining patent in 9 patients. Both fistulous orifice and carotid were embolized in 3 cases, because the balloon catheter couldn't enter fistulous orifice (2 cases) or the fistulous orifice was too large (one case). After the treatment all the patients became symptom free except for one patient who remained blind.Conclusion Being less invasive, more safe and effective, endovascular embolization with detachable balloon is the best method for treating TCCF.