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Transvenous embolization of carotid - cavernous sinus fistula via the inferior petrosal sinus pathway
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1001-2346.2005.06.007
- Key Word:
- 颈动脉海绵窦瘘;岩下窦;静脉入路
Abstract： 目的探讨经岩下窦静脉入路治疗颈动脉海绵窦瘘(CCF)的疗效.方法经股静脉-岩下窦入路到达病变侧海绵窦,用各种弹簧圈如GDC、EDC、Matrix、Free Coil和丝线等多种材料填塞海绵窦,同时闭塞瘘口.结果经股静脉-岩下窦入路对18例、21侧海绵窦进行了栓塞治疗.16例治疗后造影显示海绵窦和瘘口完全闭塞,无静脉引流;2例虽将海绵窦瘘口密实填塞,但仍有低流量翼丛引流,术后临床症状减轻,压颈1周后症状消失.栓塞术后病人主要表现为头痛和呕吐.2例术前伴有动眼神经麻痹病人,栓塞治疗后其他症状消失,但动眼神经功能未恢复.1例栓塞术后出现一过性外展神经麻痹,后自行恢复.有7例为外伤性,经动脉途径球囊栓塞后复发,或经弹簧圈治疗未成功.有11例为自发性,除3例岩下窦引流不明显,经硬导丝努力打通该通路,余者岩下窦均引流明显,导丝较易通过.随访3个月至24个月,6例病人术后3个月回医院行全脑血管造影检查,未发现复发;余者因术后无症状未回医院复查.结论经岩下窦静脉入路治疗CCF安全有效,对于外伤性CCF,为经动脉入路失败后治疗该病的主要治疗方法,而对于自发性CCF,应作为首选治疗.
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