[1]王武,李明华,李永东,等.经动脉途径血管内治疗５１例外伤性直接性颈动脉海绵窦瘘[J].介入放射学杂志,2010,(04):281.
　WANG Wu,LI Minghua,LI Yongdong,et al.Transarterial endovascular treatment of traumatic direct carotid－cavernous fistulas：a report of ５１cases[J].journal interventional radiology,2010,(04):281.
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经动脉途径血管内治疗５１例外伤性直接性颈动脉海绵窦瘘()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2010年04期
页码:
281
栏目:
神经介入
出版日期:
2010-04-15

文章信息/Info

Title:
Transarterial endovascular treatment of traumatic direct carotid－cavernous fistulas：a report of ５１cases
作者:
王武; 李明华; 李永东; 等
２００２３３上海交通大学附属第六人民医院介入影像科
Author(s):
WANG Wu ; LI Ming－hua; LI Yong－dong; TAN Hua－qiao; GU Bin－xian; FANG Chun; XU Hao－wen; WANG Ju; ZHANG Pei－lei．
the Affiliated Sixth People’s Hospital，School of Medicine，Shanghai Jiaotong University，Shanghai２００２３３，China
关键词:
外伤性直接性颈动脉海绵窦瘘; 血管内治疗; 外伤; 可脱球囊; Willis覆膜支架
分类号:
R７４３.３
摘要:
目的推介最近５年经动脉途径使用可脱球囊、弹簧圈和Willis覆膜支架血管内治疗外伤性直接性颈动脉海绵窦瘘（TDCCFs ）和保留颈内动脉（ICA）的经验。方法回顾性分析经动脉途径血管内治疗的５１例患者的５４处TDCCFs ，均首选可脱球囊作为治疗方法，Willis覆膜支架和弹簧圈作为备选方法，术后３～４８个月行脑血管造影和临床随访评价所有患者的治疗效果。结果一期单纯性可脱球囊成功治疗４６处（８５．２％）TDCCFs ，并保留了ICA。使用可脱球囊、弹簧圈和Willis覆膜支架合计保留了５３处（９８．１％）TDCCFs 的ICA，同时成功闭塞瘘口，仅１例闭塞了单侧ICA和瘘口。单纯可脱球囊治疗４０处TDCCFs ，单纯Willis覆膜支架治疗２处TDCCFs ，单纯弹簧圈治疗１处TDCCF，可脱球囊联合Willis覆膜支架治疗８处TDCCFs ，联合弹簧圈治疗３处TDCCFs ，其中１处使用了Willis覆膜支架治疗。１２处TDCCFs 进行了二期和三期治疗。除外５例患者单侧视力损害和（或）脑神经麻痹无明显改善外，术后１d～６个月其他病例症状呈阶梯型改善，直到消失。术中无一例患者血管破裂、无远端脑栓塞和新发神经系统症状等并发症。５１处TDCCFs 在最后１次治疗后６个月随访无复发。结论经动脉途径使用可脱球囊栓塞TDCCFs 的瘘口和保留ICA仍然是其首选的方法，但当这个方法失败时，Willis覆膜支架和弹簧圈可以作为有效的替换方法或补救措施闭塞瘘口和保留ICA，而使用Willis覆膜支架是有效、安全和经济实用的治疗方法，但需更多的病例作远期随访，以进一步拓展它的适应证

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备注/Memo

备注/Memo:
收稿日期：２０１０－０２－０４
更新日期/Last Update: 2010-04-15