【摘要】 目的介绍血管内介入治疗28例病人共29个颈动脉海绵窦瘘(CCF)的经验。方法将病人分为栓塞组(21例共21个CCF)和带膜支架组(7例共8个CCF),分别使用可脱球囊或弹簧圈栓塞术和带膜支架技术治疗,评价临床效果和影像学变化,比较CCF的闭塞率和ICA的通畅率。结果所有病例术后临床症状消失,无手术相关死亡。所有病例的CCF均完全闭塞,栓塞组ICA通畅占14/21,带膜支架组ICA通畅占7/8。结论可脱球囊或弹簧圈栓塞术和带膜支架技术都是血管内治疗CCF的有效方法。初步的研究结果提示带膜支架技术在保持颈内动脉通畅方面可能优于可脱球囊或弹簧圈栓塞术,但仍需更大规模、更长随访时间的随机研究来进一步证实该技术在血管内治疗CCF中的价值。更多还原

【Abstract】 Objective Carotid cavernous fistulae are now mainly treated with detachable balloons or coils.Coronary stent grafts have been sporadically used in the intracranial arteries and only a few case studies have been reported in the literature.We present 28 patients with 29 CCFs treated with either detachable balloons/coils or stent grafts.Methods Patients were divided into 2 groups:Group A and B.In group A,21 patients with 21 CCFs were treated with detachable balloons or coils.In group B,7 patients with 8 CCFs were treated with stent grafts.All of the patients were periodically followed up for 6~96 months.Results In all cases,the symptoms related to the CCF regressed after treatment and did not reoccur during the follow-up.There was no mortality related to CCF and all CCFs were occluded completely.The patency rate of group B(14/21) is slightly higher compared with group A(7/8).Conclusions Both detachable balloons/coils and stent grafts are efficient therapeutic alternatives for CCF.Stent grafts may be better in preserving the parent ICA.However,a larger trial with long-term follow-up is needed to further confirm the role of stent graft in the endovascular treatment of CCF.更多还原