Willis覆膜支架置入术治疗创伤性颈动脉海绵窦瘘7例

Willis covered stent in the treatment of traumatic carotid cavernous fistulae: a report of 7 cases

目的评价Willis覆膜支架治疗创伤性颈动脉海绵窦瘘(traumatic carotid cavernous fistula, tCCF)的有效性和安全性。方法回顾性分析2015年11月至2018年6月期间上海市浦南医院应用Willis覆膜支架治疗的7例tCCF患者的影像学和临床资料。结果7例患者共使用7枚Willis支架。其中6例支架释放后即刻造影示瘘口完全消失;1例存在少量内漏,予以再次球囊扩张后仍有少量内漏,未做进一步处理。无手术操作并发症。3~12个月随访时,所有患者均无新发神经功能缺损;2例患者血管造影随访显示瘘口完全消失,未复发,颈内动脉通畅,无支架内狭窄和支架移位。结论Willis覆膜支架可作为tCCF的治疗方法,疗效满意,安全性良好。

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF). Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively. Results Seven Willis covered stent were used in 7 patients. Immediately after stent release, angiography showed that the fistulae completely disappeared in 6 cases. One patient had a small amount of endoleak, and there was still a small amount of endoleaks after balloon dilatation. It was not further treated. There were no operative complications. During 3-12 months follow-up, no new neurological deficits were found in all patients. Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence. The internal carotid arteries were patent, no in-stent stenosis and stent displacement. Conclusions Willis covered stent can be used as a treatment for tCCF. Its efficacy is satisfactory and the safety is good.