外伤性颈动脉海绵窦瘘19例血管内治疗  

Experiences of endovascular treatment for TCCF in 19 cases

作　　者：许友松[1] 杨平[1] 张建[1] 徐英辉[1] 刘荣耀[1] 廉志刚[1] 

机构地区：[1]大连医科大学第一临床学院神经外科,辽宁大连116011

出　　处：《大连医科大学学报》2005年第6期444-445,共2页Journal of Dalian Medical University

摘　　要：[目的]总结19例外伤性颈动脉海绵窦瘘(TCCF)的血管内治疗经验。[方法]全部采用全脑血管造影(DSA)可脱球栓塞术。[结果]临床治愈率94.7%,无永久性手术并发症。5例(侧)复发而行第2次球囊栓塞术,复发率23.8%,颈内动脉保留率68.4%。[结论]球囊栓塞术复发原因除颅骨骨折断端刺破球囊外,还可能与球囊老化,球囊内外渗透压差有关。减少球囊充填的剂量或选用稍大型号球囊可以减少复发。复发病例再次栓塞术的难度增大。不得已闭塞颈内动脉时,主张于瘘口的远近端放置2枚球囊。根据本组病例,额面部着力的减速性损伤易发生TCCF。[ Objective] To generalize the experiences of endovascular treatment for 19 cases. [ Methods] A Retrospective of the review was conducted on 19 patients who underwent cerebral angiogram and detached balloon occlusion for CCF. [ Result] The curative rate is 94.7%. There is no death and permanent neurological deficits related to the procedures. Five lesions need second treatment because of recurrence, accounting for 23.8%. The internal carotid artery was preserved in 13 cases, accounting for 68.4%. [ Conclusion] Detached ballon embolization is the first choice of treatment for TCCF. The recurrence reasons included sharp margins of cranial bone rupture the ballon , fatigue of valve, and the different osmolarity between inside and outside of ballon. Some slight filling of a larger ballon is a method of preventing recurrence. In the recurrent cases, the navigation of an additional ballon is more apt to unsuccessful. When occlusion of internal carotid artery is necessary , both the proximal and distal part of internal carotid artery should be occluded. According to the these cases , TCCF were often resulted from decelerated trauma of frontal and facial parts .

关 键 词：外伤 颈动脉海绵窦瘘 血管内治疗 球囊栓塞术 血管造影 可脱球栓塞术 

分 类 号：R651.12[医药卫生—外科学]