介入栓塞治疗外伤性颈动脉海绵窦瘘的疗效  

A comparative study of the clinical efficacy of different interventional embolization in the treatment of traumatic carotid cavernous sinus fistula

作　　者：王凯[1] 秦虎[1] WANG Kai;QIN Hu(Department of Neurosurgery Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院神经外科中心,新疆乌鲁木齐830011

出　　处：《医学影像学杂志》2023年第2期211-214,共4页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金项目(编号:2021D01C339)。

摘　　要：目的 探讨介入栓塞治疗外伤性颈动脉海绵窦瘘(TCCF)的临床疗效及影像学变化。方法 选取77例TCCF患者的临床资料,按照不同的手术治疗方法分为球囊辅助弹簧圈栓塞(球囊辅助组35例)、可脱性球囊栓塞(可脱性球囊组38例)、Willis覆膜支架栓塞(覆膜支架组4例),分析栓塞术后的影像学表现和预后。结果 77例患者共计手术84台次,行一次栓塞治疗70例,两次栓塞治疗7例。总体治愈率100%,颈内动脉通畅率97.4%。球囊辅助组与可脱性球囊组相比完全闭塞率、手术并发症发生率、一次性栓塞治愈率无明显差异。所有患者随访显示疗效可靠。结论 球囊辅助弹簧圈和可脱性球囊栓塞方法可作为治疗TCCF的首选方案,安全可靠。Objective To explore clinical efficacy and imaging changes of different interventional embolization for traumatic carotid cavernous sinus fistula(TCCF). Methods The clinical data of 77 patients with TCCF admitted in our hospital from were collected. They were divided into balloon-assisted coils embolism(balloon assisted group, n=35), detachable balloon embolism(detachable balloon group, n=38), Willis covered stent embolism(covered stent group, n=4) according to different surgical treatment methods, and the imaging manifestations and perioperative indicators of the two groups after interventional embolization were compared, and a one-year follow-up was performed after treatment. The imaging findings, surgical complications and prognosis of patients after interventional embolization were retrospectively analyzed, and a one-year follow-up was conducted. Results 77 patients were operated 84 times in total, 70 patients(90.9%) were operated once and 7 patients(9.01%) were operated twice.The overall recovery rate was 100%, and the patency rate of internal carotid artery was 97.4%. There was no significant difference between balloon assisted group and detachable balloon group in total occlusion rate, surgical complication and one-time surgical recovery rate. All patients were followed up and shown reliable efficacy. Conclusion Balloon assisted coil and detactable balloon embolization can be the first choice for the treatment of TCCF. The imaging findings of patients have been significantly improved after treatment, which should be selected based on the actual situation to obtain a better prognosis and safety.

关 键 词：介入栓塞治疗 外伤性颈动脉海绵窦瘘 围术期指标 影像学表现 

分 类 号：R8154[医药卫生—放射医学] R543.4[医药卫生—临床医学]