Wang Y-L, Ma J, Ding P-X, Li Y-D, Han X-W, Wu G
Department of Interventional Radiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Interv Neuroradiol. 2012 Jun;18(2):172-7. doi: 10.1177/159101991201800208. Epub 2012 Jun 4.
We describe our preliminary experience on the feasibility of using the Willis covered stent in patients with carotid-cavernous fistulas (CCFs). Eleven consecutive patients with post-traumatic CCFs referred for treatment with Willis covered stents were enrolled into this prospective study, and were subsequently followed-up at our hospital. Data on technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome, was collected, with follow-up performed at one, three, six and 12 months, and yearly thereafter. Deployment of the covered stents was technically successful in all patients. Angiographic results following stent placement showed a complete occlusion in eight patients with ten CCFs, and an incomplete occlusion in three. No adverse events occurred either during or after the procedure. Angiographic follow-up (mean 14.73 ± 6.77 months) revealed complete occlusion and no obvious in-stent stenosis in all patients. Clinical follow-up (mean 17.73 ± 6.48 months) demonstrated full recovery in ten patients, and improvement in one. These preliminary results indicate that the use of the Willis covered stent is a feasible procedure, and that it may therefore serve as an alternative treatment for CCFs. Longer follow-up assessments and an expanded clinical trial are needed.
我们描述了使用Willis覆膜支架治疗颈内动脉海绵窦瘘（CCF）患者的可行性的初步经验。连续11例因创伤后CCF而转诊接受Willis覆膜支架治疗的患者被纳入这项前瞻性研究，并随后在我院进行随访。收集了关于技术成功率、初始和最终血管造影结果、死亡率、发病率和最终临床结局的数据，随访在1、3、6和12个月时进行，此后每年进行一次。所有患者的覆膜支架置入在技术上均获成功。支架置入后的血管造影结果显示，10处CCF中的8例患者实现完全闭塞，3例不完全闭塞。术中及术后均未发生不良事件。血管造影随访（平均14.73±6.77个月）显示所有患者均实现完全闭塞且无明显支架内狭窄。临床随访（平均17.73±6.48个月）显示10例患者完全康复，1例有所改善。这些初步结果表明，使用Willis覆膜支架是一种可行的治疗方法，因此可作为CCF的一种替代治疗手段。需要进行更长时间的随访评估和扩大临床试验。
