自发性颈动脉海绵窦瘘的介入治疗  

The intravascular embolization of spontaneous carotid cavernous fistula.

作　　者：孙树清[1] 吴中学[1] 刘道坤[2] 邓传宗[2] 陈建[2] 蔡用武[2] 

机构地区：[1]北京市神经外科研究所 [2]南通医学院附属医院神经外科

出　　处：《中国神经精神疾病杂志》2004年第5期353-356,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的 探讨自发性颈动脉海绵窦瘘的诊治方法。方法 9例单纯颈内动脉供血,其中6例采取球囊瘘内闭塞术,3例采用瘘口一同闭塞的颈内动脉闭塞术。11例采用微导管超选择性插管,行瘘的供血动脉及瘘口栓塞。栓塞后7例仍有供血者3例经压颈1个月瘘口消失,2例疗效不满意,患者未再来治疗,2例采取经岩下窦途径和经眼静脉途径。1例单纯由颈内动脉脑膜支供血的行γ刀治疗。结果 13例栓塞后造影瘘口完全闭塞,7例栓塞后造影瘘口有显影,术后采取压迫患侧颈总动脉1个月,半年后3例造影瘘口消失,2例疗效不满意,失去随访,2例经眼静脉、岩下窦栓塞海绵窦取得成功。γ刀治疗1例,症状消失。19例随访6个月未见瘘口再通。结论 介入栓塞是治疗自发性颈动脉海绵窦瘘行之有效的方法。Objective To study the pathogenesis and treatmem of spontaneous carotid cavernous fistulas. Methods 20 cases were embolized via endovascular approach, including one treated byγ knife. In the 20 cases, 9 were embolized by detachable balloon catheter, with 3 cases occluded in ICA. Other 11 cases were embolized with particles, threads, free coils, and glue via arterial approach. 2 cases were embolized by microcoils through inferior petrosal sinus and superior ophthalmic vein approach. Results In 13 of the 20 cases the fistulas were completely embolized angiographically. The fistulas were partly embolized in 1 of 20 cases. The carotid artery was compresses for 1 month, the fistulas of 3 cases disappeared angiographically. 2 cases were embolized by microcoils through inferior petrosal sinus and superior ophthalmic vein approach into the cavernous sinus. Two cases still existed fistula, and then lost follow up. 1 case was cured by y knife. Fistulas of 19 cases disappeared during the follow up for 6 months. Conclusions Endovascular treatment of spontaneous carotid cavernous fistula may be an effectivetherapy.

关 键 词：自发 颈动脉海绵窦瘘 栓塞 

分 类 号：R743[医药卫生—神经病学与精神病学]