Endovascular treatment of pseudo-aneurysm occurring after embolization of traumatic carotid cavernous fistula with detachable balloons  

作　　者：FANG Chun LI Ming-hua TAN Hua-qiao ZHANG Pei-lei ZHOU Bin 

机构地区：[1]Department of Radiology, Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China

出　　处：《Chinese Medical Journal》2008年第15期1487-1491,共5页中华医学杂志（英文版）

摘　　要：Traumatic carotid-cavemous fistula （CCF） is an abnormal passageway between the intracavemous carotid artery and the cavernous sinus after a head injury. Most CCFs have direct high flow. Clinical presentations primarily depend on the pressure inside the cavernous sinus and on the direction of the venous drainage. The ideal goal for the treatment of direct CCF is the obliteration of the fistula while preserving the internal carotid artery （ICA）. Transarterial embolization of direct CCF with detachable balloons has been proven to be the best option for an initial treatment, although transarterial embolization by detachable balloons is frequently associated with pseudo-aneurysm formation. Many treatment options such as coiling, stent-assisted coiling, and covered stent have been proposed to treat pseudo-aneurysm. However, the best management for a pseudo-aneurysm occurring after an embolization of a CCF with detachable balloons remains unknown. In this article, we will report our successful attempt in treating the said pseudo-aneurysm. We initially dealt with a pseudo-aneurysm occurring after an embolization of a CCF with stent-assisted coiling; then, the pseudoaneurysm recanalized, and eventually a covered stent was placed for the recanalized pseudoaneurysm.Traumatic carotid-cavemous fistula （CCF） is an abnormal passageway between the intracavemous carotid artery and the cavernous sinus after a head injury. Most CCFs have direct high flow. Clinical presentations primarily depend on the pressure inside the cavernous sinus and on the direction of the venous drainage. The ideal goal for the treatment of direct CCF is the obliteration of the fistula while preserving the internal carotid artery （ICA）. Transarterial embolization of direct CCF with detachable balloons has been proven to be the best option for an initial treatment, although transarterial embolization by detachable balloons is frequently associated with pseudo-aneurysm formation. Many treatment options such as coiling, stent-assisted coiling, and covered stent have been proposed to treat pseudo-aneurysm. However, the best management for a pseudo-aneurysm occurring after an embolization of a CCF with detachable balloons remains unknown. In this article, we will report our successful attempt in treating the said pseudo-aneurysm. We initially dealt with a pseudo-aneurysm occurring after an embolization of a CCF with stent-assisted coiling; then, the pseudoaneurysm recanalized, and eventually a covered stent was placed for the recanalized pseudoaneurysm.

关 键 词：carotid-cavernousfistula PSEUDO-ANEURYSM covered stent endovascular treatment 

分 类 号：R654.3[医药卫生—外科学]