球囊辅助弹簧圈联合Onxy胶治疗颈内动脉海绵窦瘘的疗效分析  

Efficacy of balloon-assisted sinus coiling plus Onxy embolization technique in the treatment of carotid cavernous fistula

作　　者：刘泠 吴娅秋[1] 王奇 谭海斌[1] 程美雄[1] 张天[1] Liu Ling;Wu Yaqiu;Wang Qi;Tan Haibin;Cheng Meixiong;Zhang Tian(Department of Neurosurgery,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院神经外科,成都610072

出　　处：《中华脑科疾病与康复杂志（电子版）》2020年第2期94-98,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探讨球囊辅助弹簧圈联合Onxy胶治疗颈内动脉海绵窦瘘(CCF)的安全性及有效性。方法四川省医学科学院·四川省人民医院神经外科自2018年1月至2020年6月共收治CCF患者19例,均采用球囊辅助弹簧圈联合Onxy胶介入治疗。其中11例岩下窦开放者行经岩下窦静脉途径栓塞治疗,另8例行经颈内动脉瘘口动脉途径栓塞。结果19例患者栓塞后即刻造影显示海绵窦瘘口完全封闭。术后常规复查头颅CT,未见栓塞剂异位栓塞表现,无新发神经功能障碍表现。所有患者于术后即刻眼静脉症状及颅鸣耳鸣症状均有明显缓解,1~2周内逐步消失。而存在颅神经麻痹症状患者,眼外肌麻痹症状缓解则相对缓慢。结论通过三维成像后处理剪辑技术,可精准判断瘘口位置;无论经动脉或静脉入路,封堵球囊可精准封闭瘘口,在栓塞过程中使弹簧圈及Onxy胶尽可能接近瘘口附近,从而减少费用,同时提高CCF治疗的安全性及有效性,减少并发症。Objective To discuss the safety and efficacy of balloon-assisted sinus coiling plus Onxy embolization technique in the treatment of carotid cavernous fistula(CCF).Methods Nineteen cases of CCF admitted into the Department of Neurosurgery of Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital from January 2018 to June 2020,are retrospectively studied.Balloon-assisted sinus coiling plus Onxy embolization technique was conducted in all cases.Among them,11 cases with open inferior petrosal sinus were treated with embolization via inferior petrosal sinus vein,and 8 cases were treated with transcatheter arterial embolization via internal carotid artery fistula.Results Immediate obliteration of the fistula was achieved in all cases,without additional neurological dysfunction.Symptoms resulting from ophthalmic vein hypertension relieved evidently immediately after the surgery and gradually disappeared within 1-2 weeks.The symptoms of extraocular muscle paralysis were relieved relatively slowly.Conclusion Through imaging editing technique after 3D-image reconstruction,the location of fistula can be accurately determined,making the coil and Onxy glue as close to the fistula as possible,so as to reduce the cost,improve the safety and efficacy of CCF treatment.

关 键 词：颈内动脉海绵窦瘘 栓塞 静脉入路 动脉入路 

分 类 号：R743.4[医药卫生—神经病学与精神病学]