Covered stents for the endovascular treatment of a direct carotid cavernous fistula : single center experiences with 10 cases.
Covered stents for the endovascular treatment of a direct carotid cavernous fistula : single center experiences with 10 cases.
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DOI：
10.3340/jkns.2015.57.1.12
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发表时间：
2015-01
影响因子：
1.6
通讯作者：
Han MH
中科院分区：
文献类型：
--
作者：
Li K;Cho YD;Kim KM;Kang HS;Kim JE;Han MH
覆膜支架是治疗颈动脉海绵窦瘘(DCCF)的有效替代方法。本研究的目的是描述我们应用覆膜支架治疗DCCF的经验，并评价覆膜支架是否有可能作为部分病例的首选支架。从2009年2月到2013年7月，10名患者接受了覆膜支架置入术治疗DCCF闭塞。对临床和血管造影资料进行回顾性分析。5名患者主要作为第一选择进行带膜支架置入，另外5名患者作为替代选择。所有患者(100%)均成功进入和部署覆膜支架，9例(90%)瘘管完全闭塞。5例(50%)术后即刻完全闭塞。5名患者持续存在内漏，4名患者通过一个月的对照血管造影术发现瘘管完全闭塞。另一名患者接受了经静脉途径的额外弹簧圈栓塞术。在手术过程中发现两例与球囊充气相关的动脉剥离；在后续的血管造影术中观察到愈合。1例患者在治疗7个月后出现无症状的颈内动脉闭塞。尽管内漏目前是一个常见的障碍，但我们的经验表明，覆膜支架有可能成为DCCF的首选支架；随着该装置经验的积累和材料的不断改进，这种潜力可能会增加。
Covered stent has been recently reported as an effective alternative treatment for direct carotid cavernous fistulas (DCCFs). The purpose of this study is to describe our experiences with the treatment of DCCF with covered stents and to evaluate whether a covered stent has a potential to be used as the first choice in selected cases. From February 2009 through July 2013, 10 patients underwent covered stent placement for a DCCF occlusion. Clinical and angiographic data were retrospectively reviewed. Covered stent placement was performed for five patients primarily as the first choice and in the other five as an alternative option. Access and deployment of a covered stent was successful in all patients (100%) and total occlusion of the fistula was achieved in nine (90%). Complete occlusion immediately after the procedure was obtained in five patients (50%). Endoleak persisted in five patients and the fistulae were found to be completely occluded by one month control angiography in four. The other patient underwent additional coil embolization by a transvenous approach. Balloon inflation-related arterial dissection during the procedure was noted in two cases; healing was noted at follow-up angiography. One patient suffered an asymptomatic internal carotid artery occlusion noted seven months post-treatment. Although endoleak is currently a common roadblock, our experience demonstrates that a covered stent has the potential to be used as the first choice in DCCF; this potential is likely to increase as experience with this device accumulates and the materials continue to improve.
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影响因子：
2.3
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通讯作者：
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