带膜支架治疗双侧外伤性颈动脉海绵窦瘘  

Treatment of bilateral traumatic carotid cavernous fistulae with endovascular covered stent deployment

作　　者：胡锦清[1] 林东[1] 沈建康[1] 王懿[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经外科,上海200025

出　　处：《中华神经医学杂志》2006年第1期79-81,共3页Chinese Journal of Neuromedicine

摘　　要：目的报道1例双侧外伤性颈动脉海绵窦瘘(TCCF)采用带膜冠脉支架治愈病变并保持颈内动脉(ICA)的通畅。方法一58岁男性重度颅脑外伤患者出现搏动性突眼伴杂音,脑血管造影显示双侧TCCF。服用抗血小板药物3d后在全身麻醉下把JostentGraftmaster冠脉带膜支架分别置入双侧瘘口所在的ICA。结果复查造影见瘘口完全闭塞,杂音立即消失,数天后结膜水肿消退,无操作所产生的并发症出现。结论带膜支架是TCCF的一种可供选择的治疗方法,特别适合于无法保留ICA通畅或者无法耐受ICA闭塞的的患者。Objective To report a patient with bilateral traumatic carotid cavernous fistulae （TCCF） who was successfully treated with endovascular covered stent deployment. Methods A 58-year-old male patient with severe head injury presented with pulsatile exophthalmos and bruit. The cerebral angiogram revealed bilateral TCCF. The preservation of ICA in bilateral TCCF patient is very important, so we decided to use coverd stents to occlude the fistulae. After receiving antiplatelet drugs for 3 d, the patient underwent bilateral covered stent implantation by endovascular approach under the general anesthesia. Results The bilateral TCCF were successfully treated by endovascular deployment of expandable coronary PTFE-covered stents （Jostent GraftMaster covered stents 3.5 mm×12 mm and 3.5 mm×16 mm） in bilateral ICA. The angiogram immediately after the intervention revealed obliteration of bilateral TCCF and both ICAs were fully patent. The bruit disappeared immediately after covered stent implantation and the chemosis of both eyes disappeared several days later. No complications related with the endovascular therapy were observed. Conclusion Covered stent implantation is an alternative method for TCCF, especially suitable for the patient whose ICA is cannot be preserved by detachable balloon or the patient who cannot tolerate the ICA occlusion.

关 键 词：外伤性颈动脉海绵窦瘘 介入治疗 带膜支架 

分 类 号：R651.1[医药卫生—外科学]