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Onyx胶联合弹簧圈栓塞治疗Barrow A型创伤性颈内动脉海绵窦瘘的疗效和安全性 |
李司司,于瀛,许奕,黄清海,洪波,方亦斌,赵瑞,李强,刘建民* |
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(海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433 *通信作者) |
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摘要: |
目的 探讨Onyx胶联合弹簧圈栓塞治疗创伤性颈内动脉海绵窦瘘(TCCF)的安全性、有效性,并总结治疗经验。方法 回顾性分析2009年1月至2020年6月于我院脑血管病中心接受Onyx胶联合弹簧圈栓塞治疗的50例Barrow A型TCCF患者资料。评估Onyx胶联合弹簧圈栓塞术后患者的影像学及临床结果,通过临床随访及影像学随访评估预后。结果 50例TCCF患者中男27例(54%)、女23例(46%),年龄为17~78岁,平均年龄为(45±15)岁。所有患者均有不同程度的症状(突眼、球结膜充血、眼球活动受限、颅内杂音等)。栓塞术后即刻造影显示46例(92%)瘘口消失,4例(8%)瘘口少量残留;术后患者相关症状均有不同程度的缓解或消失。2例(4%)患者发生围手术期并发症。随访时间4(2~9)个月,随访期间复查造影示所有患者瘘口均完全消失,除3例遗留视力障碍、1例遗留眼肌麻痹症状外,余患者症状均消失。结论 Onyx胶联合弹簧圈栓塞治疗TCCF安全、有效,是治疗TCCF的理想方式之一。 |
关键词: 创伤性颈动脉海绵窦瘘 介入治疗 Onyx胶 弹簧圈 治疗性栓塞 |
DOI:10.16781/j.0258-879x.2021.08.0927 |
投稿时间:2020-09-24修订日期:2021-06-30 |
基金项目: |
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Efficacy and safety of Onyx combined with coil embolization in treating Barrow type A traumatic carotid cavernous fistula |
LI Si-si,YU Ying,XU Yi,HUANG Qing-hai,HONG Bo,FANG Yi-Bin,ZHAO Rui,LI Qiang,LIU Jian-min* |
(Stroke Center, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China *Corresponding author) |
Abstract: |
Objective To investigate the safety and efficacy of Onyx combined with coil embolization in the treatment of traumatic carotid cavernous fistula (TCCF), and to summarize the treatment experience. Methods The data of 50 patients with Barrow type A TCCF who received Onyx combined with coil embolization in our center from Jan. 2009 to Jun. 2020 were retrospectively analyzed. The imaging and clinical results were evaluated after treatment. The prognosis was evaluated by clinical and imaging follow-up. Results There were 27 males (54%) and 23 females (46%) in 50 TCCF patients, with an average age of (45±15) years (range, 17-78 years). The patients had varying degrees of symptoms (exophthalmos, bulbar conjunctival congestion, limited eye movement, intracranial murmurs, etc.). The fistulas disappeared in 46 cases (92%) immediately after the procedure, and little residuals were found in 4 cases (8%). The related symptoms were relieved or disappeared to different extents. Perioperative complications occurred in 2 patients (4%). The follow-up duration was 4 (2-9) months. During the follow-up period, fistulas completely disappeared in all patients and the remaining symptoms also disappeared, except for 3 cases of visual impairment and 1 case of ophthalmoplegia. Conclusion Onyx combined with coil embolization is safe and effective in the treatment of TCCF, and it is one of the ideal ways to treat TCCF. |
Key words: traumatic carotid cavernous fistula interventional therapy Onyx coil therapeutic embolization |