Selective transvenous embolization of dural carotid-cavernous sinus fistulas with preservation of sylvian venous outflow. Report of three cases.
Selective transvenous embolization of dural carotid-cavernous sinus fistulas with preservation of sylvian venous outflow. Report of three cases.
复制标题
选择性经静脉栓塞治疗硬脑膜颈动脉海绵窦瘘并保留侧裂静脉流出。
DOI：
10.3171/foc.1998.5.4.14
复制
发表时间：
1998
影响因子：
4.1
通讯作者：
S. Fujita
中科院分区：
文献类型：
--
作者：
Mitsugu Nakamura;Norihiko Tamaki;T. Kawaguchi;S. Fujita
描述了一种可以避免正常脑静脉引流的经静脉栓塞术。作者治疗的26例颈内动脉海绵窦瘘中，3例海绵窦区既有分流，又有侧支静脉引流。两名患者出现外展神经麻痹，一名患者出现动眼神经麻痹。海绵窦瘘管部分的选择性经静脉栓塞术得以实现，同时保留了侧翼静脉流出。栓塞后血管造影术显示1例瘘管完全闭塞，另外2例仅有少量残余分流。其中一人接受了随后的动脉栓塞术，另一人没有接受额外治疗。治疗后1~2个月，患者症状消失。随访血管造影显示残馀分流消失，侧翼静脉通路得以保留。作者得出结论，经静脉选择性栓塞术可用于治疗累及海绵窦的硬脑膜动静脉瘘，该海绵窦也接受侧翼静脉流出。
A transvenous embolization technique in which normal cerebral venous drainage can be spared is described. Of 26 dural carotid--cavernous fistulas treated by the authors, the affected cavernous sinus received not only the shunted flow but also the sylvian venous drainage in three cases. Two patients presented with an abducent nerve palsy, and one with an oculomotor nerve palsy. Selective transvenous embolization of the fistulous portions of the affected cavernous sinus was achieved, with preservation of the sylvian venous outflow. Postembolization angiograms revealed complete occlusion of the fistula in one patient and only a small amount of residual shunt in the other two. One of these two underwent subsequent transarterial embolization, and the other was followed without additional treatment. The patients' symptoms resolved between 1 and 2 months posttreatment. Follow-up angiograms revealed that the remnant shunt had disappeared and the sylvian venous pathway had been preserved. The authors conclude that selective transvenous embolization of fistulous compartments in an affected sinus can be used to treat dural arteriovenous fistulas involving a cavernous sinus that also receives the sylvian venous outflow.