颈动脉海绵窦瘘的DSA评价和栓塞治疗(附126例报告)

DSA Evaluation and Embolization Treatment of Carotid Cavernous Fistulas (Reports of 126 Cases)

目的 探讨数字减影血管造影对颈动脉海绵窦瘘诊断的价值 ,并通过对其血管造影表现的分析 ,指导栓塞治疗。方法 12 6例颈动脉海绵窦瘘进行DSA检查 ,每例患者均行超选择颈内、外动脉造影 ,同时将本组病例分为 4类。结果 12 6例颈动脉海绵窦瘘中 ,A型瘘 88例 ;B型瘘 11例 ;C型瘘 2 3例 ;D型瘘 12例。 88例直接瘘造影确定瘘口位置 ,瘘口位于颈内动脉海绵窦Ⅰ段 5例 ;Ⅱ段 2 9例 ;Ⅲ段 11例 ;Ⅳ段 34例 ;Ⅴ段 9例。根据DSA表现 ,10 2例采用经股动脉途径栓塞 ,2 2例经眼上静脉途径。结论 数字减影血管造影可较好地显示颈动脉海绵窦瘘的位置和大小 ,同时 ,可以有效地评价Willis环功能 ,为其栓塞治疗提供有价值的信息。在CCF的治疗中可脱性球囊栓塞是最理想的首选方法。

Purpose To investigate the role of DSA in the evaluation of carotid cavernous fistulas and to direct embolization treatment. Methods Cerebral angiography and selective exteral and interal carotid angiographies were carried out in 126 patients,and were classified into 4 types. Results By careful observation and analysis of DSA films,the 126 patients were classified into type A 88 cases; type B 11 cases; type C 23 cases; type D 12 cases. Five of 88 cases direct fistulas were located at C1 of the cavernous segment. 29 cases at C2;11 cases at C3;34 cases at C4 and 9 cases at C5. In 126 patients carotid cavernous fistulas embolizaton treatment, with the femoral approach was adopted in 102 cases, the superior opthalmic vein approach in 22 cases. Conclusion DSA is helpful in locating the sites in CCF patients,in evaluating function of Willis circles and providing valuable information,and intravascular occlusion using detachable balloon is the method of choice in the treatment of CCF.