血管内栓塞治疗颈动脉海绵窦瘘  

Endovascular Embolization in the Treatment of Carotid Cavernous Fistula

作　　者：阳纲要[1] 武衡[1] 谢明[1] 林百喜[1] 

机构地区：[1]南华大学第一附属医院神经介入中心,湖南衡阳421001

出　　处：《南华大学学报（医学版）》2006年第2期217-220,共4页Journal of Nanhua University(Medical Edition)

摘　　要：目的探讨颈动脉海绵窦瘘血管内栓塞治疗。方法回顾性分析2003年至2005年收治的9例患者,所有患者均行全脑血管数字减影血管造影检查明确诊断。根据供血动脉进行影像分型,不同类型选择了不同的治疗方法。6例A型病例经动脉途径进行球囊栓塞,1例C型病例及1例D型病例经静脉途径进行弹簧圈栓塞。结果5例A型病例一次可脱性球囊闭塞瘘口成功,1例A型病例球囊早泄复发、2周后再次球囊栓塞成功,1例C型病例经眼上静脉2次弹簧圈填塞海绵窦治愈,1例D型病例经岩下窦一次填塞海绵窦治愈。1例A型病例造影后当天因颅内再次出血死亡。结论根据不同影像分型选择相应的治疗方法是提高颈动脉海绵窦瘘栓塞治疗疗效的关键。Objective To assess the effect on endovascular embolotherapy of carotid cavernous fistulas （ CCFs）. Methods 9 CCF cases diagnosed by digital subtraction anglography（DSA） and 8 cases treated with endovascular embolization were retrospectively analyzed. The different methods were selected according to the types of DSA. Of all the 9 cases, 6 cases of A type were treated with detachable balloon through transarterial approach , one case of C type and one case of D type were treated with coils through transvenous approach. Results 5 cases （A type） of fistula were totally blocked one time with detachable balloon, one case（A type） was recurred because of balloon early demoralization, and was successely blocked again after two weeks. One case（C type） was retrogradely embolized twice via ophthahnic vein with coil and one case（D type） was blocked once through inferior petrosal sinus. One case died of intracranial rebleeding. Conclusions The coincident treatment approach are selected basing on the different types of DSA imagination,which is the key to improve the embolotberapy effect of CCF.

关 键 词：颈动脉海绵窦瘘 栓塞 动脉入路 静脉入路 

分 类 号：R543.4[医药卫生—心血管疾病]