[1]李天晓,白卫星,翟水亭,等.颅底动脉损伤的介入治疗[J].介入放射学杂志,2008,(08):535.
 LI Tianxiao,BAI Weixing,ZAI Suiting,et al.Endovascular treatment for arterial injuries of skull base[J].journal interventional radiology,2008,(08):535.
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颅底动脉损伤的介入治疗()

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

卷:
期数:
2008年08期
页码:
535
栏目:
神经介入
出版日期:
2008-08-15

文章信息/Info

Title:
Endovascular treatment for arterial injuries of skull base
作者:
李天晓白卫星翟水亭
450003郑州河南省人民医院介入科
Author(s):
LI Tian-xiaoBAI Wei-xingZAI Sui-tingWANG Zi-liangXUE Jiang-yu
Department of Interventional Radiology,Henan People's Provincial Hospital,Zhengzhou450003,China
关键词:
颅底损伤腔内治疗颈动脉-海绵窦瘘假性动脉瘤介入
分类号:
R743.4
文献标志码:
A
摘要:
目的探讨多种血管腔内手段治疗颅底动脉损伤的临床价值。方法2004年10月至2007年5月间我院收治各类型颅底动脉损伤患者共53例,均有头颈部外伤史。主要症状为搏动性突眼和颅内血管杂音(39例)、声嘶或吞咽不适(9例)、鼻出血(5例)等;DSA检查证实颈动脉海绵窦瘘(carotid cavernous fistulae,CCF)39例,颈内动脉假性动脉瘤14例;针对上述53例患者不同的病变特点采用不同的血管腔内治疗,并通过电话或门诊随访。结果对53例患者56支颈内动脉进行了腔内介入治疗,采用单纯可脱球囊栓塞治疗CCF33例34支血管,可脱球囊联合弹簧圈栓塞3例,植入覆膜支架封堵CCF3例;采用单纯可脱球囊闭塞颈内动脉治疗假性动脉瘤8例,可脱球囊联合弹簧圈孤立假性动脉瘤2例,植入覆膜支架腔内隔绝治疗4例;平均随访时间9.5个月(2~25个月),85%(45/53)患者主诉症状于6个月内消失,12个月随访15%(8/53)患者遗留眼球运动受限或视力障碍。复查显示存在假性动脉瘤6例,残瘘3例,其中2例因海绵窦区的硬脑膜动静脉瘘而分别于术后第2、3个月行再次介入治疗。结论对各型颅底动脉损伤,血管腔内介入治疗创伤小且安全有效。尽管存在缺陷,可脱球囊仍是治疗CCF和颈动脉假性动脉瘤的首选方法,在特殊情况下必需联合应用弹簧圈栓塞和覆膜支架植入等多种治疗手段。

参考文献/References:

[1]Vinuela F,Fox AJ ,Debrun GM,et al.Spontaneous carotid-cavernous fistulas:clinical,radiological,and therapeuticconsiderations:experience with20cases[J].J Neurosurg,1984,60:976-984.
[2]Kinugasa K,Tokunaga K,Kamata I,et al.Selection and combination of techniques for treating spontaneous carotid-cavernous sinus fistulas[J].Neurol Med Chir(Tokyo),1994,34:597-606.
[3]Miyachi S,Negoro M,Handa T,et al.Histopathological study of balloon embolization:silicone versus latex[J].Neurosurgery,1992,30:483-489.
[4]Lewis AI ,Tomsick TA,Tew JM.Management of100consecutive direct carotid cavernous fistulas:results of treatment with detachable balloons[J].Neurosurgery,1995,36:239-244.
[5]Kobayashi N,Miyachi S,Negoro M,et al.Endovascular treatment strategy for direct carotid-cavernous fistulas resulting from rupture of intracavernous carotid aneurysms [J].AJNR,2003,24:1789-1796.
[6]Kanner AA,Maimon S,Rappaport ZH.Treatment of spontaneous carotid-cavernous fistula in Ehlers-Danlos syndrome by transvenous occlusion with Guglielmi detachable coils:case report[J].J Neurosurg,2000,93:689-692.
[7]Morris PP.Balloon reconstructive technique for the treatment of a carotid cavernous fistula[J].AJNR,1999,20:1107-1109.
[8]Eddleman CS,Surdell D,Miller J,et al.Endovascular management of a ruptured cavernous carotid artery aneurysm associated with a carotid cavernous fistula with an intracranial self-expanding microstent and hydrogel-coated coil embolization:case report and review of the literature[J].Surg Neurol,2007,68:562-567.
[9]Ali Harman A,Boyvat F,Hasdogan B,et al.Endovascular treatment of active bleeding after liver transplant [J].Exp Clin Transplant ,2007,5:596-600.
[10]Fukuda I,Minakawa M,Kozo Fukui K,et al.Management of an aorto-caval fistula from a ruptured aortic false aneurysm using a covered stent graft[J].Interact Cardiovasc Thorac Surg,2007,6:682-684.
[11]Singh CS,Giri K,Gupta R,et al.Successful management of hepatic artery pseudoaneurysm complicating chronic pancreatitis by stenting[J].World J Gastroenterol,2006,21:5733-5734.
[12]Redekop G,Marotta T,Weill A.Treatment of traumatic aneurysms and arteriovenous fistulas of the skull base by using endovascular stents[J].J Neurosurg,2001,95:412-419.
[13]Laytoni KF,Yong W.Use of covered stent grafts in the extracranial carotid artery:report of three patients with follow-up between8and42months.AJNR,2004,25:1760-1763

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备注/Memo

备注/Memo:
收稿日期:2008-04-03
更新日期/Last Update: 2008-08-15