创伤性颈内动脉海绵窦瘘球囊栓塞性治疗

Balloon embolization therapy for traumatic carotid cavernous fistula

目的分析球囊栓塞性介入方法治疗创伤性颈内动脉海绵窦瘘（traumatic carotid cavemous fistula,TCCF）的临床效果，为该类疾病手术方式的选择提供参考依据。方法选择2006年4月-2012年3月收治的21例行球囊栓塞性手术治疗的TCCF患者，其中男17例，年龄（32．3±5．4）岁；女4例，年龄（40．6±5．8）岁。观察患者围术期临床症状和影像学改变，评价手术效果。结果随访3个月后，20例TCCF患者成功应用可脱球囊栓塞术，1例在进行可脱球囊栓塞术失败后采用覆膜支架成形术。在行栓塞治疗后，所有患者临床症状均有不同程度改善，与术前比较差异有统计学意义（P〈0．05）。影像学检查显示术后所有患者TCCF得到完全闭塞。随访结果显示1例出现复发症状，总治愈率为95％。结论可脱球囊栓塞性手术能有效治疗TCCF，是目前治疗该类疾病的首选手术方式之一，值得临床推广。

Objective To analyze effect of balloon embolization therapy for traumatic carotid cavernous fistula （TCCF）, so as to provide references for treatment of this disease. Methods A total of 21 patients with TCCF managed with balloon embolization from April 2006 to March 2012 were collected in the study. There were 17 males aged （32.3 ± 5.4） years and 4 females aged （40.6 ± 5.8） years. Perioperative clinical presentations and imageologie changes were observed as well as operative outcome was evaluated. Results After 3 months of follow-up, 20 patients experienced successful detachable balloon embolization, but the other one patient had to have stent angioplasty due to the failure of the procedure. All patients had some improvements on clinical presentations after operation （ P 〈 0.05 ）. Imageologie examination revealed that all patients had complete occlusion of TCCF following operation. In follow-up, one patient had a relapse, with total curative ratio of 95%. Conclusions Detachable balloon embolization is effective in treatment of TCCF. Presently, the technique is an optimal method for such kind of disease and is worthy of wide clinical use.