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首页> 外文期刊>American Journal of Neuroradiology >Placement of Covered Stents for the Treatment of Direct Carotid Cavernous Fistulas
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Placement of Covered Stents for the Treatment of Direct Carotid Cavernous Fistulas

机译：覆盖支架的放置，以治疗直接颈动脉海绵状瘘

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摘要

BACKGROUND AND PURPOSE: Endovascular detachable balloon occlusion and coil occlusion are 2 well-established options for the treatment of direct carotid cavernous fistulas (DCCFs). In recent years, covered stents have been applied in the treatment of neurovascular pathologies such as aneurysms, pseudoaneurysms, arterial dissections, and DCCFs. The purpose of this study was to investigate the clinical efficacy of covered stents for the treatment of DCCFs. MATERIALS AND METHODS: Ten consecutive patients underwent covered-stent placement after failure of detachable balloon occlusion for the treatment of their DCCFs. Clinical and angiographic follow-up ranged from 5 to 48 months (mean, 18.2 months) after stent placement. RESULTS: Stent placement was technically successful in all except 1 patient. In this patient, stent placement failed after multiple attempts because of rigidity of the Jostent GraftMaster Coronary Stent Graft and the tortuous anatomy of the internal carotid artery (ICA). Complete exclusion of the fistula was achieved in 6 patients immediately after stent deployment. Endoleak was observed in 3 patients. Re-dilation of the stent avoided the endoleak in 2 patients; in 1 of these 2 patients, formerly improved symptoms recurred the next morning and the ipsilateral ICA was occluded with detachable balloons. Spasm of the ICA was observed in most of the patients after stent placement; however, angioplasty was not required. Symptoms improved in all patients after treatment, without thromboembolic events. Follow-up cerebral angiography showed complete exclusion of all DCCFs and stent patency without intrastent stenosis in the 8 patients who had successful deployment of the stent. CONCLUSIONS: Although a larger sample and expanded follow-up are needed, our series shows that covered stents can be used in the treatment of DCCFs with symptomatic relief.
机译：背景与目的：血管内可分离球囊阻塞 和线圈阻塞是治疗直接颈动脉海绵状瘘（DCCF）的两种公认的选择。近年来， 覆膜支架已被用于治疗神经血管疾病，如动脉瘤，假性动脉瘤，动脉夹层， 和DCCF。这项研究的目的是研究 覆膜支架治疗DCCF的临床疗效。 材料与方法：十名连续患者接受覆膜支架 的可拆卸球囊闭塞失败后放置的方法。支架置入后5到48个月（平均18.2个月）进行临床和血管造影随访。 结果：除了 < / sup> 1位病人。在该患者中，由于Jostent GraftMaster冠状动脉 Stent Graft的刚度以及颈内动脉 的曲折解剖结构，多次尝试后支架放置失败（ICA）。支架展开后立即在6例患者中实现了瘘的完全排除 。在3例患者中观察到 内漏。重新扩张支架避免了2例患者的 内漏；在这2例患者中的1例中，第二天早上以前复发的症状 复发，同侧ICA被可拆卸的球囊阻塞。大多数患者在放置支架后观察到ICA的痉挛 ；但是，不需要血管成形术 。治疗后所有患者的症状均得到改善， 无血栓栓塞事件。随访脑血管造影 显示，在成功部署 的8例患者中，所有DCCF和支架通畅被完全排除，无 介入性狭窄。 结论：尽管需要更大的样本并需要扩大随访 ，但我们的系列研究表明，带盖支架可用于 治疗DCCFs。症状缓解。

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  • 来源
    《American Journal of Neuroradiology》 |2009年第7期|1342-1346|共5页
  • 作者

    C. Wang; X. Xie; C. You; C. Zhang; M. Cheng; M. He; H. Sun; B. Mao;

  • 作者单位

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

    From the Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China;

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