Spontaneous Progressive Occlusion of a Large, High-flow Direct Carotid Cavernous Fistula After Partial Treatment with Guglielmi Detachable Coils

高流量直接型頸動脈海綿竇瘻管經高尼米線圈部份栓塞後自發性封閉

黃永堅(Yung-Chien Huang) ； 廖漢文(Hon-Man Liu) ； 林瑞明(Swei-Ming Lin) ； 陳雅芳(Ya-Fang Chen) ； 鄭慶明(Chin-Ming Jeng)

《中華放射線醫學雜誌》 25卷5期 (2000/10) Pp. 215-218

摘要

直接型頸動脈海線竇瘻管的治療方式，目前是以經動脈氣球栓塞術為主。極少數無法成功地施行氣球栓塞術的病例，可以使用高尼米線圈栓塞。至日前為止，文獻報告認為中、低流量的瘻管才適合以高尼米線圈栓塞。我們報告一54歲女性病人罹患高流量直接型頸動脈海綿竇瘻管。經高尼米線圈部份栓塞後，仍有明顯的血液分流通過瘻管。但兩個月後的血管攝影發現瘻管已自動完全封閉。我們以此推論，高尼米線圈可以用於高流量頸動脈海綿竇瘻管。但需要更多的病例經驗來証實其一般可行性。

關鍵字

頸動脈海綿竇瘻管 ； 栓塞術 ； 高尼米線圈

並列摘要

Direct carotid-cavernous fistulas (CCFs) are commonly treated using the transarterial approach with detachable balloons. Occasionally, Guglielmi detachable coils (GDCs) are used in patients with mild steal of flow. The fistula can be obliterated progressively after initial incomplete treatment. It is supposed the GDCs are not suitable for patients with severe steal of flow. We present a 54-year-old woman with high-flow CCF. Balloon embolization of the fistula was tried but failed via both transarterial and transvenous approaches. We used 19 GDCs to obliterate the fistula partially. The initial result was incomplete occlusion. However, complete occlusion of the fistula was found during the follow-up angiogram 2 months after the procedure was performed. We propose that GDCs can be used to treat patients with large, high-flow CCF with severe steal.

並列關鍵字

Carotid-cavernous fistula ； Embolization ； Guglielmi detachable Coils