Kashiwagi S, Tsuchida E, Goto K, Shiroyama Y, Yamashita T, Takahasi M, Ito H
Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
Surg Neurol. 1993 Mar;39(3):187-90. doi: 10.1016/0090-3019(93)90180-9.
A case of spontaneous carotid-cavernous fistula associated with Ehlers-Danlos syndrome Type IV was treated successfully by transarterial balloon embolization. To minimize the stress to the arterial wall, we detached three silastic balloons with low-attachment force in the cavernous sinus with the aid of a proximal balloon to control the high flow of the fistula. To achieve complete obliteration, we had to inflate the third balloon to dimensions that occluded the cavernous portion of the internal carotid artery. Patients with Ehlers-Danlos syndrome Type IV carry a high risk when undergoing any diagnostic or therapeutic endovascular procedure due to the fragility of their blood vessels. Recognition of this entity is important and special attention should be paid to its pathophysiology for a successful treatment.
一例与IV型埃勒斯-当洛综合征相关的自发性颈动脉海绵窦瘘经动脉球囊栓塞术成功治疗。为了将对动脉壁的压力降至最低，我们借助近端球囊在海绵窦内分离了三个附着力低的硅橡胶球囊，以控制瘘管的高流量。为了实现完全闭塞，我们不得不将第三个球囊膨胀到闭塞颈内动脉海绵窦段的尺寸。IV型埃勒斯-当洛综合征患者由于血管脆弱，在接受任何诊断或治疗性血管内手术时都有很高的风险。认识到这一实体很重要，为了成功治疗，应特别关注其病理生理学。
