外伤性颈内动脉海绵窦瘘并严重鼻衄的血管内介入治疗  

Endovascular interventional treatment of traumatic carotid cavernous fistula with serious epistaxis

作　　者：唐军[1] 陈颉[1] 张垒[1] 李继军[1] 刘作勤[1] 

机构地区：[1]山东省医学影像学研究所介入放射研究室,山东济南250021

出　　处：《医学影像学杂志》2012年第11期1788-1790,共3页Journal of Medical Imaging

摘　　要：目的探讨血管内介入治疗外伤性颈内动脉海绵窦瘘(TCCF)合并严重鼻衄的策略和疗效。方法 26例TCCF并严重鼻衄的患者进行了血管内介入治疗,其中24例采用了可脱性球囊栓塞瘘口或闭塞颈内动脉;1例采用解脱式微弹簧圈栓塞;1例采用覆膜支架进行治疗。结果 26例中,9例1次性栓塞了瘘口,假性动脉瘤消失,颈内动脉通畅;15例1次性栓塞了瘘口和闭塞颈内动脉;解脱式微弹簧圈栓塞海绵窦,瘘口基本消失,颈内动脉通畅1例;覆膜支架闭塞瘘口,颈内动脉保持通畅1例。术后26例均未再发生鼻衄。结论 TCCF并严重鼻衄应尽早进行DSA确诊,尽早或急症进行治疗。血管内介入治疗TCCF合并严重鼻衄是一种首选、安全和有效的治疗方法。Objective To discuss the efficiency and strategy of interventional treatment of traumatic carotid cavernous fistula （TCCF） with serious epistaxis. Methods Of 26 cases of TCCF with serious epistaxis, 24 cases were treated by in- terventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid ar- tery, 1 case was embolized by detachable micro-coi!, and 1 case was treated with stent by occlusion orificium and pseudo- aneurysm. Results Fistula was embolized successfully and internal carotid artery remained in 9 cases, complete emboliza- tion of orificium and internal carotid artery was achieved in 15 cases, cavernous sinus was embolized by detachable micro- coil and internal carotid artery remained in 1 case, Fistula was embolized by membrane stent and internal carotid artery re- mained in 1 case. No case recurred. Conclusion DSA examination is necessary to diagnosing TCCF with serious epistaxis. Intravascular embolization is safe and efficient therapy to TCCF with serious epistaxis. It is the first choice especially in e- mergency.

关 键 词：外伤性颈内动脉海绵窦瘘 鼻衄 介入性 栓塞 

分 类 号：R543.4[医药卫生—心血管疾病] R815[医药卫生—内科学]