摘要
在场的 ObjectiveTo 我们在在我们的医院里与在 2004 年 1 月和 2012 年 10 月之间的 TCCF 由 28 个病人的多模式的 endovascular treatment.MethodsThe 管理对待创伤的颈动脉多孔的管(TCCF ) 的经验回顾地被分析。根据成像 charateristics， 24 个盒子被分成类型我， 3 类型 II 和 1 类型 III。完全， 30 endovascular 治疗被执行：类型我 TCCF 经由 transvenous 被涂抹途径(7/25 ) ，或由可拆卸的汽球吸藏的包括 6 的 transarterial 途径(18/25 ) ， 6 由 microcoil embolization， 3 由 Hyperglide 帮助汽球的卷 embolization 并且 3 由可拆卸的汽球和卷 embolization 的联合。二个病人与内部颈动脉动脉(集成通信适配器) 的闭合被对待。类型 II TCCF 与 transvenous embolotherapy (2/3 ) 或颈动脉动脉压缩治疗(1/3 ) 被对待。类型 III 病人经历了手术后的 angiography 显示出的可拆卸的汽球 embolization.ResultsImmediate 在 26 种情况中的恢复。一周期性的 TCCF 2 个星期在可拆卸的汽球 embolization 以后被发现，然后由 transarterial 卷重新涂抹。重考在可拆卸的汽球和卷 embolization 的联合以后在 1 病人一月内发现了汽球放气和管开运河，它被第二治疗经由 transvenous 途径治好。立即的 angiography 在 4 个病人揭示了剩余血流动。在他们之中，有在后续的推迟的症状的 2 个病人需要第二治疗， 1 个病人在颈动脉动脉压缩治疗以后恢复了，并且留下的 patient’s 症状消失在在五月的后续的数字减法 angiography 上。CT angiography 在与集成通信适配器的闭合被对待的病人揭示了前面的交流动脉动脉瘤到图象，管的特征和排水的类型的结果的 4 年 later.ConclusionAccording 能最大地愈合病理学的变化，保留 ipsilateral 集成通信适配器明显并且减少长期的复杂并发症。
bjective：To present our experience in treating traumatic carotid-cavernous fistula （TCCF） by multimodal endovascular treatment.Methods：The management of 28 patients with TCCF between January 2004 and October 2012 in our hospital was retrospectively analyzed.According to imaging charateristics,24 cases were categorized into Type Ⅰ,3 Type Ⅱ and 1 Type Ⅲ.Totally 30 endovascular treatments were performed：Type Ⅰ TCCFs were obliterated via transvenous approach （7/25）,or transarterial approach （18/25） including 6 by detachable balloon occlusion,6 by microcoil embolization,3 by Hyperglide balloon-assisted coil embolization and 3 by a combination of detachable balloon and coil embolization.Two patients were treated with closure of internal carotid artery （ICA）.Type Ⅱ TCCFs were treated with transvenous embolotherapy （2/3） or carotid artery compression therapy （1/3）.The Type Ⅲ patient underwent detachable balloon embolization.Results：Immediate postoperative angiography showed recovery in 26 cases.One recurrent TCCF was found 2 weeks after detachable balloon embolization,and then reobliterated by transarterial coils.Reexamination found balloon deflation and fistula recanalization in 1 patient one month after combination of detachable balloons and coil embolization,which was cured by a second treatment via transvenous approach.The immediate angiography revealed residual blood flow in 4 patients.Among them,2 patients with delayed symptoms at follow-up needed a second treatment,1 patient recovered after carotid artery compression therapy,and the remaining patient＇s symptoms disappeared on digital subtraction angiography at five-month follow-up.CT angiography revealed anterior communicating artery aneurysm in the patient who was treated with closure ofICA 4 years later.Conclusion：According to results of images,characteristics of the fistula and type of drainage,proper treatment approach and embolic material can maximally heal pathological changes,retain the ipsilateral ICA patency and reduce long-term complications.
