Chen Li-zhao, Xu Min-hui, Yang Dong-hong, Zou Yong-wen, Zhang Yun-dong
Department of Neurosurgery, Daping Hospital, Third Military Medical University, Chongqing, China.
Chin J Traumatol. 2010 Feb;13(1):20-4.
To retrospectively analyze 95 cases of traumatic carotid cavernous fistula treated by endovascular embolization.
From January 1994 to December 2008, 95 patients with traumatic carotid cavernous fistula were treated in our hospital. All patients received selective cerebral angiography through femoral artery catheterization. Accordingly, 89 cases were treated by detachable balloon embolization, 5 by platinum microcoils and 1 by covered-stent, respectively.
In the study, 61 cases achieved successful balloon embolization at the first time. Fifty-six cases had multiple balloons due to the big fistula. Nine cases received balloon embolization twice. But among the 5 patients treated with platinum microcoils, one developed slight brainstem ischemia. After operation the patient had hemiparesis and swallow difficulty, but gradually recovered 3 months later. No neurological deficits were observed in other cases. All the cases recovered. Eighty-five cases were followed up for 1-15 years and no recurrence was found.
The endovascular embolization for traumatic carotid cavernous fistula is minimally invasive, safe, effective and reliable. The detachable balloon embolization is the first choice in the treatment of TCCF.
回顾性分析95例经血管内栓塞治疗的外伤性颈内动脉海绵窦瘘。
1994年1月至2008年12月，我院收治95例外伤性颈内动脉海绵窦瘘患者。所有患者均经股动脉插管行选择性脑血管造影。其中，89例采用可脱性球囊栓塞治疗，5例采用铂金微线圈栓塞治疗，1例采用覆膜支架治疗。
本研究中，61例首次球囊栓塞成功。56例因瘘口较大使用多个球囊。9例接受了两次球囊栓塞。但在5例采用铂金微线圈治疗的患者中，1例出现轻微脑干缺血。术后患者出现偏瘫和吞咽困难，但3个月后逐渐恢复。其他病例未观察到神经功能缺损。所有病例均康复。85例随访1至15年，未发现复发。
血管内栓塞治疗外伤性颈内动脉海绵窦瘘具有微创、安全、有效、可靠的特点。可脱性球囊栓塞是治疗外伤性颈内动脉海绵窦瘘的首选方法。
