摘要
目的 探讨颈动脉海绵窦瘘 (CCF)的治疗方法选择、栓塞技术要点及随访意义。方法 对 2 16例CCF病人共行 2 2 0次栓塞 ,其中 ,经股动脉入路 2 0 2例 ,经股静脉入路 9例 ,经眼上静脉入路 5例 ;以球囊栓塞瘘口 188例 ,以微弹簧圈栓塞 2 3例 ,球囊并用弹簧圈 5例。术后 6～ 10 8个月随访 110例 ,其中行影像学复查 3 5例。结果 2 12例 1次栓塞成功 ,4例于第一次栓塞后球囊泄漏复发 ,经再次栓塞治愈 ,总治愈率 10 0 %。颈内动脉通畅率 94 4% (2 0 4/2 16) ,无并发症及死亡 ,随访显示疗效可靠。结论 CCF一般经股动脉入路用可脱性球囊栓塞瘘口 ,栓塞时球囊应稳步前进 ,一旦扩充 ,决不轻易后拉。小瘘口CCF选择微弹簧圈栓塞 ;若颈内动脉结扎或闭塞 ,可经静脉入路栓塞瘘口。正确选择栓塞途径及栓塞材料是手术成功的关键。
Objective To investigate the outcome of the treatment of CCF by different approaches and embolization materials. Methods Of all 216 patients with CCF, 220 procedures for embolizations were done. 202 patients were punctured by femorl artery route, 9 patients by femoral vein route, and 5 patients by the supper occipital vein. For the embolization materials, balloons were used in 188 cases, microcoils were used in 23 cases, and both materials were used in 5 cases. After the embolization, 110 patients were followed for 6～108 months, and 35 patients had repeated angiography. Results 212 CCFs were embolized success fully at the first time, 4 cases failed because of balloons leaking. All 4 CCFS were embolized successfully in the second attempt. The total success rate was 100%. The rate of internal carotid artery patency was 94 6%(204/216). There was no perioperative mortality or complication. None of the CCF recurred when assessed during follow up. Conclusions In general, the CCF can be successfully treated by balloons embolization via femoral artery. For small fistula, microcoils embolization are better. Embolization can be done by venous approach when the internal carotid artery was ligation. Right choices of the approach and the embolization materials are the key to success of surgery.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2000年第6期321-323,共3页
Chinese Journal of Nervous and Mental Diseases
