双球囊技术在外伤性颈动脉海绵窦瘘治疗中应用探讨  

Discussion on the application of dual-balloon technique in treating traumatic carotid-cavernous fistula

作　　者：吴亮[1] 冯大勤[2] 周传凯[1] 黄国洲[1] 廖振南 WU Liang;FENG Daqin;ZHOU Chuankai;HUANG Guozhou;LIAO Zhennan(Department of Cerebrovascular Disease,Qinzhou Municipal Second People’s Hospital,Qinzhou,Guangxi Zhuang Autonomous Region 535000,China)

机构地区：[1]钦州市第二人民医院脑血管病科,广西535000 [2]广西医科大学第一附属医院神经外科

出　　处：《介入放射学杂志》2021年第9期866-869,共4页Journal of Interventional Radiology

摘　　要：目的总结双球囊技术(不可解脱球囊辅助可解脱球囊)在外伤性颈动脉海绵窦瘘(CCF)治疗中的应用经验,分析其适用范围及技术要点。方法回顾性分析采用双球囊技术行介入治疗的18例Barrow A型外伤性CCF患者。治疗过程中先在瘘口远心端放置不可解脱球囊,然后放置可解脱球囊靠近瘘口区域,适当充盈不可解脱球囊辅助可解脱球囊进入瘘口,并继续缓慢充盈不可解脱球囊挤压可解脱球囊通过瘘口进入海绵窦内,最后充盈可解脱球囊闭塞瘘口。结果18例患者栓塞术后造影证实瘘口均完全闭塞获成,颈内动脉通畅。术后患者颅内杂音即刻消失,球结膜充血、水肿或突眼等症状逐步消除,无颅内缺血、出血等严重并发症。随访12~48个月,1例出现复发,仍予以双球囊技术治愈,随访18个月无复发。结论双球囊技术治疗Barrow A型外伤性CCF患者安全有效,具有创新性、可靠、费用低的特点。Objective To summarize the clinical application experience of double-balloon technique(detachable balloon assisted by nondetachable occluding balloon)in treating traumatic carotid-cavernous fistula(CCF),and to discuss its clinical application scope and technical key points.Methods The clinical data of 18 patients with traumatic CCF of Barrow type A,who received interventional treatment with dual-balloon technique,were retrospectively analyzed.The treatment steps were as follows:first,a nondetachable occluding balloon was placed at the distal end of the fistula;then,a detachable balloon was placed at the site near to fistula.The nondetachable balloon was properly inflated so as to assist the detachable balloon to enter the fistula.The nondetachable balloon was continuously inflated until the detachable balloon was forced to enter the cavernous sinus through the fistula.Finally,the detachable balloon was inflated to occlude the fistula.Results Postoperative angiography showed that successful complete occlusion of the fistula was achieved in all the 18 patients,while the internal carotid was unobstructed.Intracranial murmur disappeared immediately after the operation,and the symptoms such as congestion and edema of bulbar conjunctiva,exophthalmos,etc.faded away gradually.No serious complications such as intracranial ischemia or bleeding occurred.The patients were followed up for 12-48 months,one patient had a relapse,which was cured after receiving dual-balloon technique treatment once more and no more relapse was observed in the follow-up period lasting for 18 months.Conclusion For the treatment of Barrow type A traumatic CCF,this innovative dual-balloon technique is safe,effect and reliable with lower medical expense.

关 键 词：颈动脉海绵窦瘘 介入治疗 外伤 

分 类 号：R543.1[医药卫生—心血管疾病]