Mizuno T, Kai Y, Todaka T, Morioka M, Hamada J, Ushio Y
Department of Neurosurgery, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto-city, Kumamoto 860-8556, Japan.
No Shinkei Geka. 2001 Oct;29(10):961-4.
We report a case of a patient with a spontaneous carotid-cavernous sinus fistula (CCF) who was successfully treated by the facial vein approach. This 66-year-old female had a 3-month history of right chemosis and exophthalmos. Angiograms showed a spontaneous right CCF with primary drainage via the superior ophthalmic vein. As both inferior petrosal sinuses were hypoplastic, the transvenous approach could not be used to gain access to the right cavernous sinus. With effort, we were able to traverse the sharp angle at the corner of the angular vein and the superior ophthalmic vein with a microcatheter. Thereafter, it was easily navigated into the right cavernous sinus. Successful placement of Guglielmi detachable coils resulted in complete closure of the fistula. When it is difficult to gain access to the cavernous sinus via the inferior petrosal sinus, the facial vein approach is a useful alternative.
我们报告一例通过面静脉入路成功治疗的自发性颈内动脉海绵窦瘘（CCF）患者。这位66岁女性有3个月的右侧结膜充血和眼球突出病史。血管造影显示为自发性右侧CCF，主要通过眼上静脉引流。由于双侧岩下窦发育不全，无法采用经静脉入路进入右侧海绵窦。经过努力，我们用微导管穿过了角静脉与眼上静脉拐角处的锐角。此后，微导管很容易进入右侧海绵窦。成功植入 Guglielmi 可脱性弹簧圈导致瘘口完全闭合。当难以通过岩下窦进入海绵窦时，面静脉入路是一种有用的替代方法。
