背景:直接颈动脉海绵窦瘘(CCF)是高流量动静脉分流,通常是严重颅脑损伤的结果。这些病变的血管内治疗包括使用可拆卸的球囊,线圈,液体栓塞剂,和覆盖支架。为了尽量减少治疗失败和后续并发症的机会,可以将使用流动转向支架的腔内重建添加到治疗构造中。
方法:我们介绍3例,并复习现有文献。
结果:三名直接创伤性CCF患者接受了两种线圈治疗,线圈和玛瑙,或者一个可拆卸的气球,然后放置分流支架进行腔内重建。所有3例病例的CCF血管造影完全闭塞,临床恢复。未观察到并发症。
结论:我们认为,经静脉或动脉途径血管内线圈或球囊闭塞瘘管,然后分流可能是直接CCF的适当治疗方法。分流器的添加可以促进颈内动脉损伤的内皮化。
BACKGROUND: Direct carotid-cavernous sinus fistulas (CCFs) are high-flow arteriovenous shunts that are typically the result of a severe head injury. The endovascular treatment of these lesions includes the use of detachable balloons, coils, liquid embolic agents, and covered stents. To minimize the chance of treatment failure and subsequent complications, endoluminal reconstruction using a flow-diverting stent may be added to the treatment construct.
METHODS: We present 3 cases and review the existing literature.
RESULTS: Three patients with direct traumatic CCFs were treated with either coils, coils and Onyx, or a detachable balloon, followed by placement of a flow-diverting stent for endoluminal reconstruction. All 3 cases had complete angiographic occlusion of the CCFs and recovered clinically. No complications were observed.
CONCLUSIONS: We believe that endovascular coil or balloon occlusion of the fistula from either a transvenous or transarterial approach followed by flow diversion may be an appropriate treatment for direct CCFs. This addition of a flow diverter may facilitate endothelialization of the injury to the internal carotid artery.