医学
海绵窦
外科
放射科
无症状的
眼上静脉
瘘管
岩下窦
颈动脉海绵窦瘘
血栓形成
闭塞
血管内治疗
回顾性队列研究
神经组阅片室
颈动脉海绵窦瘘
神经介入放射学
神经学
动脉瘤
精神科
作者
John E. Sanderson,Bongani M. Mayosi,Salim Yusuf,Soumya M. Reddy,Song Hu,Zhengming Chen,Adam Timmis
出处
期刊:Heart
[BMJ]
日期:2007-09-21
卷期号:93 (10): 1175-1175
被引量:195
标识
DOI:10.1136/hrt.2007.131060
摘要
Objectives: To report clinical characteristics, angiographical findings and results of endovascular treatment of patients presenting with dural carotid–cavernous fistulas (DCCFs). Method: Retrospective analysis of 27 consecutive patients with DCCF referred to a specialised interventional neuroradiology department. Results: Orbital and neuro-ophthalmological symptoms were the most common clinical presentation at diagnosis (n = 25). The venous drainage of the fistula involved the ipsilateral superior ophthalmic vein in 24 patients, the contralateral cavernous sinus in 6 and a leptomeningeal vein in 5 patients. Thrombosis of at least one petrosal sinus was found in 23 patients. 7 patients did not receive endovascular treatment: 3 had spontaneous DCCF obliteration, and 4 had only minor clinical symptoms and no leptomeningeal venous drainage on an angiogram. 20 patients received endovascular treatment via either a transvenous (n = 16) or a transarterial approach (n = 4). Complete occlusion of the fistula was obtained in 14 of 16 (87%) patients treated by the transvenous approach and in 1 of 4 (25%) patients treated by the transarterial approach. 16 patients had early clinical improvement after endovascular treatment. One patient had a cerebral haemorrhage after transvenous embolisation of a DCCF with leptomeningeal drainage. On follow-up, all patients treated by the transarterial route remained symptomatic, whereas 10 of 14 (71%) patients cured by the transvenous route were asymptomatic. Conclusions: Transvenous embolisation is a safe and efficient endovascular approach to treat patients with DCCF. However, this technique requires a long learning curve.
科研通智能强力驱动
Strongly Powered by AbleSci AI