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经动脉栓塞治疗硬脑膜型颈内动脉海绵窦瘘

[Transarterial embolization of dural carotid-cavernous fistulas].

作者信息

Chen Huai-rui, Bai Ru-lin, Wu Xiao-jun, Hu Guo-han, Luo Chun, Lu Yi-cheng

机构信息

Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Nov 11;88(41):2924-7.

Abstract

OBJECTIVE

To explore the efficacy and strategy of transarterial embolization of dural carotid-cavernous fistulas.

METHODS

The clinical data of 19 patients with dural carotid-cavernous fistulas treated by transarterial embolization, including clinical presentations and patterns of angioarchitecture were retrospectively analyzed. Follow-up was conducted for 7 months to 4 years.

RESULTS

Clinical cure was achieved in 15 cases, significant improvement of symptoms in 3 cases, and failure in 1 case. Complete angiographic obliteration was documented in 12 patients (63%) right after the embolization. Residual shunting was left in 6 patients, and disappeared in 5 cases one month to half a year later by manual compression of the carotid artery. The patient on which transarterial embolization failed received embolization via the bilateral cavernous later, and clinical cure was achieved. Headache and vomiting were the most common symptoms after embolization. There was no permanent procedure-related morbidity. No recurrence was seen during the follow-up.

CONCLUSION

Transarterial embolization is a safe, efficient and economical method for part of the cavernous sinus dural arteriovenous fistula patients.

摘要

目的

探讨经动脉栓塞治疗硬脑膜型颈内动脉海绵窦瘘的疗效及策略。

方法

回顾性分析19例经动脉栓塞治疗的硬脑膜型颈内动脉海绵窦瘘患者的临床资料,包括临床表现及血管构筑类型。随访7个月至4年。

结果

15例临床治愈,3例症状明显改善,1例失败。栓塞后即刻血管造影显示12例(63%)完全闭塞。6例有残余分流,其中5例经压迫颈动脉1个月至半年后分流消失。经动脉栓塞失败的患者经双侧海绵窦栓塞后临床治愈。头痛和呕吐是栓塞后最常见的症状。无永久性与手术相关的并发症。随访期间未见复发。

结论

经动脉栓塞对部分海绵窦区硬脑膜动静脉瘘患者是一种安全、有效且经济的治疗方法。

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