Angiographic follow-up of traumatic carotid cavernous fistulas treated with endovascular stent graft placement.

Angiographic follow-up of traumatic carotid cavernous fistulas treated with endovascular stent graft placement.
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血管内支架移植治疗创伤性颈动脉海绵窦瘘的血管造影随访。

DOI:
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发表时间:
2007
期刊:
AJNR. American journal of neuroradiology
影响因子:
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通讯作者:
G. Scialfa
G. Scialfa
中科院分区:
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文献类型:
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作者:
E. Archondakis;G. Pero;L. Valvassori;E. Boccardi;G. Scialfa

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背景及目的
BACKGROUND AND PURPOSE Endovascular treatment (EVT) of carotid cavernous fistulas (CCFs) is based on various techniques, mainly those using detachable balloons. Coronary covered stent grafts have been sporadically used in the intracranial arteries and only 2 traumatic CCFs have been reported in the literature; moreover, there is poor information about the long-term follow-up. We present 8 cases of CCFs treated by the placement of a covered stent, 5 of which have a 1-year clinical and angiographic follow-up. METHODS Eight patients with posttraumatic CCF were treated by positioning a covered stent in the intracranial internal carotid artery (ICA) to occlude the fistula. They received periodic clinical and angiographic follow-up to evaluate the patency and the stability of clinical results. RESULTS In all cases, the symptoms related to the CCF regressed after treatment and did not recur in the follow-up. Two patients presented residual filling of the CCF at the end of the procedure. The angiographic follow-up revealed in 6 patients of 7 a good patency of the ICA; in 1 patient, there was an ICA asymptomatic occlusion. One patient required transvenous coil occlusion of the cavernous sinus. CONCLUSION When standard treatments fail, covered stent grafts can be used as a valid alternative in the treatment of CCFs, but more data are needed, especially in the long-term follow-up.