Dai Rong-Qin, Bai Wei-Xing, Gao Bu-Lang, Li Tian-Xiao, Zhang Kun
Department of Intensive Medicine, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, PR China.
Department of Interventional Therapy, Henan Provincial Hospital of Cerebrovascular Diseases, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, PR China.
Interv Neuroradiol. 2020 Feb;26(1):83-89. doi: 10.1177/1591019919864668. Epub 2019 Jul 23.
To investigate the mid- and long-term effects of parent artery occlusion on the carotid cavernous fistula and on the quality of life of patients.
One hundred and twenty-six patients with high-flow direct carotid cavernous fistulas were enrolled. The modified Rankin scale scores, the headache impact test and the short form health survey scores were used to evaluate the patients' clinical status.
Fifty-two patients had parent artery occlusion, while the rest of the 74 patients had embolization of carotid cavernous fistulas with parent artery preservation. No periprocedural complications occurred. Eighteen patients in the parent artery occlusion group had low perfusion symptoms within two weeks following embolization, and three patients had Horner's syndrome on the ipsilateral side. At two months' follow-up, the patients with parent artery occlusion had a significantly ( < 0.05) greater proportion of headache than patients with parent artery preservation. At 12 months, no significant ( > 0.05) difference existed in the headache impact test scores in both groups. At 36 months' follow-up, the patients with parent artery occlusion had decreased SF-30 scores in all the eight health domains compared with patients treated with parent artery preservation, with a significant ( < 0.05) lower score in general health, vitality and bodily pain in the parent artery occlusion compared with the parent artery preservation group. No recurrence was shown in patients with parent artery occlusion, but nine (12.2%) patients were recurrent in patients with parent artery preservation.
Parent artery occlusion may affect the quality of life of patients with carotid cavernous fistulas despite being an effective treatment option for high-flow direct fistulas.
探讨颈内动脉闭塞术对海绵窦瘘及患者生活质量的中长期影响。
纳入126例高流量直接型海绵窦瘘患者。采用改良Rankin量表评分、头痛影响测试及简短健康调查问卷评分评估患者的临床状况。
52例患者接受了颈内动脉闭塞术，其余74例患者采用保留颈内动脉的海绵窦瘘栓塞术。围手术期未发生并发症。颈内动脉闭塞组18例患者在栓塞术后两周内出现低灌注症状，3例患者出现同侧霍纳综合征。随访2个月时，颈内动脉闭塞组患者头痛的比例显著高于保留颈内动脉组（<0.05）。随访12个月时，两组头痛影响测试评分无显著差异（>0.05）。随访36个月时，与保留颈内动脉治疗的患者相比，颈内动脉闭塞组患者在所有8个健康领域的SF-30评分均降低，颈内动脉闭塞组在总体健康、活力和身体疼痛方面的评分显著低于保留颈内动脉组（<0.05）。颈内动脉闭塞组患者未出现复发，但保留颈内动脉组有9例（12.2%）患者复发。
尽管颈内动脉闭塞术是治疗高流量直接型海绵窦瘘的有效方法，但可能会影响海绵窦瘘患者的生活质量。
