Mørkve Svein Harald, Wathle Gaute Kjellevold, Logallo Nicola
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Orbit. 2025 Aug;44(4):407-414. doi: 10.1080/01676830.2024.2448802. Epub 2025 Jan 20.
Carotid-cavernous fistulas (CCFs) are treated almost exclusively by endovascular techniques, but the frequency of treatments is limited in smaller centers. We analyzed all CCFs treated in our hospital to determine if high-quality treatment of CCFs can be provided in a medium-volume neurovascular center.
Retrospective quality-control cohort study.
From 2005 to 2021, 28 CCF-treatments were performed in our hospital, all endovascular. Fourteen were direct and fourteen were indirect CCFs. All direct CCFs were treated using transarterial coil embolization, and in seven of these the ICA was preserved. All indirect CCFs were treated using transvenous coil embolization. Complete cure was achieved after one procedure in 24 (85.7%) patients, and in all patients (100%) after retreatments. All CCF-patients experienced significant improvement of symptoms after treatment and 79.2% were asymptomatic after 6-12 months. Two patients with direct CCFs were blind on their ipsilateral eye before treatment and remained so after treatment. Three patients had reduced vision or visual field defects ipsilateral to their indirect CCFs that normalized after treatment. One patient suffered a minor asymptomatic thromboembolic event during the treatment (3.6%), otherwise there were no complications to treatments.
High-quality treatment of CCFs can be provided in a medium-volume neurovascular center.
颈动脉海绵窦瘘（CCF）几乎完全通过血管内技术进行治疗，但在较小的中心，治疗频率有限。我们分析了我院治疗的所有CCF，以确定在一个中等规模的神经血管中心是否能够提供高质量的CCF治疗。
回顾性质量控制队列研究。
2005年至2021年，我院共进行了28例CCF治疗，均为血管内治疗。其中14例为直接CCF，14例为间接CCF。所有直接CCF均采用经动脉线圈栓塞治疗，其中7例保留了颈内动脉（ICA）。所有间接CCF均采用经静脉线圈栓塞治疗。24例（85.7%）患者在一次治疗后实现完全治愈，所有患者（100%）在再次治疗后实现完全治愈。所有CCF患者在治疗后症状均有显著改善，79.2%的患者在6 - 12个月后无症状。2例直接CCF患者在治疗前患侧眼睛失明，治疗后仍失明。3例间接CCF患者患侧视力下降或有视野缺损，治疗后恢复正常。1例患者在治疗期间发生轻微无症状血栓栓塞事件（3.6%），除此之外，治疗无其他并发症。
在一个中等规模的神经血管中心能够提供高质量的CCF治疗。
