外伤性颈动脉海绵窦瘘的血管内治疗

Intravascular embolization for treating traumatic carotid cavernous fistula

目的探讨外伤性颈动脉海绵窦瘘的血管内治疗的技术特点。方法对于不同的病例采用了不同的方法,包括海绵窦瘘口球囊栓塞,保持颈内动脉通畅,以及连同瘘口闭塞的颈内动脉闭塞术。对于动脉途径难以进行的病例采取了经静脉途径弹簧圈的栓塞。结果53例球囊闭塞瘘口且保持颈内动脉通畅。14例连同瘘口闭塞颈内动脉。3例通过静脉途径栓塞满意。结论外伤性颈动脉海绵窦瘘应首选血管内栓塞治疗。一般情况下海绵窦瘘均表现为良性过程,应力争解剖治愈,不可轻易牺牲颈内动脉。

Objective To explore technical characteristics of the intravascular embolization for treating traumatic carotid cavernous fistula (TCCF). Methods 82 patents (men 69, women 13) with TCCF were treated with different approaches based on the different illness states: occlude the fistula with balloon while keeping carotid artery unembolized; occlude the fistula and internal carotid artery simultaneously; if difficult via artery, occlude it via vein with coils. Results The fistulas only were embolized in 53 cases; the fistulas as well as internal carotid artery were embolized in 14 cases; the embolization were performed via vein in 3 cases. Conclusion The preferred therapy of TCCF is intravascular embolization. Generally speaking, cavernous fistula showing benign process should be cured anatomically with no sacrifice of the internal carotid artery.