Patients with CCFs undergoing transorbital endovascular treatment at our institution between 2017 and 2019 were retrospectively reviewed. Demographic, treatment, and outcome data were collected.
Eight patients met inclusion criteria, 4 female and 4 male patients. The mean age was 43 years, with 6 right-sided CCF and 2 left-sided CCFs. Symptoms were present for an average of 1.5 months before treatment. All patients presented with eye pain and subjective visual changes. Seven (87.5%) patients presented with proptosis, 6 (75%) patients had elevated intraocular pressure (IOP), and 3 (37.5%) patients had ophthalmoplegia. Six CCFs (75%) were spontaneous, and 2 CCFs (25%) were traumatic. Barrow types were A (n = 1), B (n = 1), C (n = 1), and D (n = 5). All patients underwent direct percutaneous transorbital embolization with coils followed by Onyx. Three patients had undergone prior transarterial and/or transvenous treatment. A radiographic cure was obtained in all patients after direct transorbital embolization. After CCF cure, cranial nerve palsies resolved in 66.7% of patients, visual acuity in the affected eye was improved or stable in 75% of patients, and IOP had normalized in 85.7% of patients. Proptosis improved in all patients, with complete resolution in 75%.
Direct transorbital embolization is a safe and potentially curative treatment for all 4 Barrow types of CCFs.
方法:回顾性分析2017年至2019年在我院接受经眶腔内治疗的CCF患者。人口统计,治疗,并收集结果数据。
结果:8例患者符合纳入标准,4名女性患者和4名男性患者。平均年龄是43岁,有6个右侧CCF和2个左侧CCF。症状在治疗前平均出现1.5个月。所有患者均出现眼痛和主观视觉改变。7例(87.5%)患者出现眼球突出,6例(75%)患者眼压升高(IOP),3例(37.5%)患者有眼肌麻痹。六个CCF(75%)是自发的,2个CCF(25%)是创伤性的。巴罗类型为A(n=1),B(n=1),C(n=1),和D(n=5)。所有患者均接受直接经皮经眶栓塞,然后使用线圈和Onyx。三名患者先前经历了经动脉和/或经静脉治疗。直接经眶栓塞后,所有患者均获得了影像学治愈。CCF固化后,66.7%的患者颅神经麻痹得到缓解,75%的患者患眼视力得到改善或稳定,85.7%的患者眼压恢复正常。所有患者的前突都得到了改善,具有75%的完整分辨率。
结论:对于所有4种Barrow类型的CCF,直接经眶栓塞是一种安全且潜在治愈的治疗方法。