Park Jungyul
Department of Ophthalmology, School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
J Cerebrovasc Endovasc Neurosurg. 2023 Sep;25(3):245-252. doi: 10.7461/jcen.2023.E2022.10.005. Epub 2023 Feb 28.
Carotid-cavernous fistulas, characterized by abnormal arteriovenous communication within the cavernous sinus (CS), can be classified as direct or indirect. Direct fistulas are defined as a direct connection between the internal carotid artery (ICA) and CS, whereas indirect fistulas result from an abnormal connection between the CS and dural arterial branches. The first-line treatment for both types of fistulas is endovascular intervention, most commonly accomplished through the transarterial and transvenous approaches of the conventional pathway, including the ICA, inferior and superior petrosal sinuses, or basilar plexus. Nonetheless, a retrograde approach through the superior ophthalmic vein may be necessary for individuals in whom conventional endovascular treatment fails. Herein, the current principles of surgical indication and technique are presented, along with case studies.
海绵窦瘘以海绵窦（CS）内异常动静脉交通为特征，可分为直接型和间接型。直接瘘定义为颈内动脉（ICA）与CS之间的直接连接，而间接瘘则是由于CS与硬脑膜动脉分支之间的异常连接所致。这两种类型瘘的一线治疗方法是血管内介入，最常见的是通过传统路径的经动脉和经静脉途径来完成，包括ICA、岩下窦和岩上窦或基底静脉丛。尽管如此，对于传统血管内治疗失败的患者，可能需要通过眼上静脉进行逆行入路。本文介绍了当前的手术指征和技术原则，并伴有病例研究。
