Debrun G, Lacour P, Vinuela F, Fox A, Drake C G, Caron J P
J Neurosurg. 1981 Nov;55(5):678-92. doi: 10.3171/jns.1981.55.5.0678.
A series of 54 traumatic carotid-cavernous fistulas has been treated with detachable balloon catheters. The balloon was introduced through one of three different approaches: the endarterial route; the venous route through the jugular vein, the inferior petrosal sinus, and the cavernous sinus; or surgical exposure of the cavernous sinus; with occlusion of the fistula by a detachable balloon directly positioned in the cavernous sinus. Full follow-up review demonstrated that the carotid blood flow was preserved in 59% of cases. The most frequent complication was a transient oculomotor nerve palsy, which occurred in 20% of cases. In three cases where both the fistula and the carotid artery were originally occluded by the balloon, the superior portion of the fistula was later found not to be completely occluded, and these patients had intracranial ligation of the supraclinoid portion of the carotid artery. Three patients had hemiparesis, transient in two cases and permanent in the other. The results show that the fistula was totally occluded in 53 cases; in the one exception the patient became asymptomatic but had a minimal angiographic leak.
采用可脱性球囊导管治疗了54例创伤性颈内动脉海绵窦瘘。球囊通过以下三种不同途径之一置入：动脉内途径；经颈静脉、岩下窦和海绵窦的静脉途径；或海绵窦的手术暴露；通过直接置于海绵窦内的可脱性球囊闭塞瘘口。全面的随访复查显示，59%的病例颈动脉血流得以保留。最常见的并发症是短暂性动眼神经麻痹，发生率为20%。在3例最初球囊同时闭塞瘘口和颈动脉的病例中，后来发现瘘口上部未完全闭塞，这些患者接受了颈动脉床突上段的颅内结扎术。3例患者出现偏瘫，2例为短暂性，另1例为永久性。结果显示，53例瘘口完全闭塞；1例例外，该患者无症状，但血管造影显示有轻微渗漏。
