覆膜支架治疗外伤性颈动脉海绵窦瘘

Covered stents in the treatment of traumatic carotid-cavernous fistulas

目的评价覆膜支架血管内治疗外伤性颈动脉海绵窦瘘（TCCF）的效果。方法郑州大学第一附属医院2009年5月至2013年8月采用覆膜支架治疗外伤性颈动脉海绵窦瘘10例，术后随访1～36个月，评价其疗效。结果10例患者覆膜支架全部植入成功，无相关手术并发症。其中4例患者应用Jostent覆膜支架，6例应用了Willis覆膜支架。8例患者使用1枚覆膜支架，2例患者使用2枚支架；术中6例支架释放后出现对比剂内漏，使用球囊于内漏端扩张后4例消失，2例仍有对比剂内漏，再次植入支架后消失；所有患者全部保留了颈内动脉（ICA）。术后随访造影显示原病变未显影，患侧ICA通畅，支架无明显狭窄。结论应用覆膜支架治疗TCCF安全、有效．可以作为TCCF的一种重要的治疗方法．

Objective To evaluate the efficacy of covered stent for endovascular treatment on traumatic carotid-cavernous fistulas. Methods From May 2009 to August 2013, lO patients with trau matic carotid cavernous fistulas were treated with covered stents. Follow-up for 1 -36 months was made to evaluate the therapeutic efficacy. Results l0 TCCFs were successfully treated with covered stent without complications. Four patients were with application of Jostent covered stents, 6 patients with appli cation of Willis covered stents. One covered stent was placed in 8 patients and two covered stents in 2. Angiographie results following stent placement showed an incomplete occlusion in eight patients. After re dilatation of balloon, the endoleaks disappeared in 4 patients. The others disappeared completely after the second covered stent was deployed in 2 patients. The internal carotid artery （ICA）was retained in all ea ses. Angiographic follow-up revealed complete occlusion, the ICAs were retained, and no obvious in stent stenosis. Conclusions Application of covered stent in the treatment of TCCF is safe, effective, and can be regarded as an important treatment option of TCCF.