Liu Yan-Chao, Duan Chuan-Zhi, Gu Da-Qun, Zhang Xin, Li Xi-Feng, He Xu-Ying, Su Shi-Xing, Lai Ling-Feng
Department of Neurosurgery, Southern Medical University, Zhujiang Hospital, 253# industry road, 510282 Guangzhou, Guangdong, PR China.
J Neuroradiol. 2014 Dec;41(5):329-35. doi: 10.1016/j.neurad.2013.10.006. Epub 2013 Dec 27.
The recovery time of traumatic carotid-cavernous fistula-induced oculomotor nerve paresis (ONP) after endovascular embolization with detachable balloons has not yet been adequately evaluated. This study was performed to make a deep analysis of the factors, which affect the prognosis of ONP after endovascular treatment of traumatic carotid-cavernous fistula (TCCF).
We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 98 consecutive patients with ONP due to traumatic carotid-cavernous fistula which were endovascular treated with detachable balloons. Univariate analysis was applied to test the association between the time of ONP recovery and clinical variables.
Ninety-eight consecutive patients (62 males, 36 females, mean age 34.2±12.7years) having presented with ONP underwent endovascular treatment with detachable balloons were enrolled in this study. ONP was complete in 22 (22.4%) patients and partial in 76 (77.6%) patients. Ninety (91.8%) patients were successfully occluded by single-session endovascular embolization. Retreatments by transarterial routes had to be performed in 8 (8.2%) patients because of recurrent fistula having occurred within 4weeks after embolization. ONP was recovered completely in all the patients, among who 4 (4.1%) were treated with occlusion of internal carotid artery. Factors showing significant association with the recovery time of ONP were the location of the fistula (P=0.007), the degree of preoperative ONP (P=0.003), the number of detachable balloon used (P=0.000) and the length of ONP before endovascular treatment (P=0.000).
Endovascular treatment of traumatic carotid-cavernous fistula-induced ONP with detachable balloons is a safe and effective method. The length of ONP before endovascular treatment, the location of the fistula, the degree of preoperative ONP, the number of detachable balloons used were the statistically significant predictors of the length of ONP complete recovery.
可脱性球囊血管内栓塞治疗创伤性颈动脉海绵窦瘘所致动眼神经麻痹（ONP）后的恢复时间尚未得到充分评估。本研究旨在深入分析影响创伤性颈动脉海绵窦瘘（TCCF）血管内治疗后ONP预后的因素。
我们回顾性评估了连续98例因创伤性颈动脉海绵窦瘘导致ONP并接受可脱性球囊血管内治疗患者的临床特征及动眼神经功能结果。采用单因素分析来检验ONP恢复时间与临床变量之间的关联。
本研究纳入了连续98例出现ONP并接受可脱性球囊血管内治疗的患者（男性62例，女性36例，平均年龄34.2±12.7岁）。22例（22.4%）患者为完全性ONP，76例（77.6%）患者为部分性ONP。90例（91.8%）患者通过单次血管内栓塞成功闭塞。8例（8.2%）患者因栓塞后4周内出现复发性瘘而不得不通过经动脉途径进行再次治疗。所有患者的ONP均完全恢复，其中4例（4.1%）患者接受了颈内动脉闭塞治疗。与ONP恢复时间显示出显著关联的因素包括瘘口位置（P = 0.007）、术前ONP程度（P = 0.003）、使用的可脱性球囊数量（P = 0.000）以及血管内治疗前ONP的持续时间（P = 0.000）。
采用可脱性球囊血管内治疗创伤性颈动脉海绵窦瘘所致ONP是一种安全有效的方法。血管内治疗前ONP的持续时间、瘘口位置、术前ONP程度、使用的可脱性球囊数量是ONP完全恢复时间的统计学显著预测因素。
