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Objective To investigate the main technical points of detachable balloon in management of traumatic carotid-cavernous fistulas (TCCF) and evaluate objectively the clinical outcome.Methods A total of 59 patients with TCCF were treated with detachable balloons,which involved 64 embolization procedures.Follow-up ranged from 3 months to 2 years. Results Forty-eight patients with TCCF (81％) were successfully occluded with patency of internal carotid artery.The rest 11 patients were obstructed in both the fistula and the internal carotid artery.Recurrent TCCF was found within three days after embolization in five patients (with a recurrence rate of 8％ ) who underwent further embolization,of whom one patient went blind after the procedtre and the eyesight showed no recovery even after another embolization with balloon for successful occlusion of the fistula; one patient presented with intracerebral hematoma at day 3 postoperatively and underwent emergency embolization again to occlude the internal carotid artery and fistula,with slight paralysis of the left limb. Conclusions Embolization of TCCF with detachable balloon is a reliable treatment,which is characterized by slight injury and high safety.However,the disease' s development should be strictly observed after the treatment.In the case of recurrence of symptoms,brain angiography and CT scanning should be rechecked timely and emergency treatment should be performed.
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Objective To evaluate the efficacy of embolization for spinal intramedullary arteriovenous malformations.Methods 25 patients with spinal intramedullary arteriovenous malformations (AVMs) were reviewed. Embolic therapy was conducted in 4 patients by introducing the tip of a catheter into the segmental arteries and injecting lyophilized dura or polyvinyl alcohol(PVA). Microcatheter were navigated into the feeding arteries and injected PVA in 9 patients, and NBCA in 7 patients. Embosphere was used after embolizing an aneurysm in the feeding artery with NBCA in one pateint. Results Spinal angiography immediately after embolization disclosed that the lesion were obliterated almost entirely in 12 cases and partially in others. The anterior or posterior spinal artery was preserved in all patients recently. The clinical follow-up period after embolization ranged from 6 to 60 months. 16 patients improved but four patients did not show any improvement.Conclusions Embolization appears to be the treatment of first choice in the management of juvenile or partial glomus AVMs which are not amenable to surgery.
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Objective To evaluate the value of three dimensional reconstruction images of rotational DSA on measuring aneurysmal necks and make a comparison with traditional DSA so as to provide more abundant and accurate informations for the enbolization of aneurysm. Methods A comparison was made between the measurement of aneurismal necks from 14 cases with traditional DSA examination and a measurement made on three dimensional reconstruction images of the same patient. Results There was a difference shown in the measurment of the aneurysmal necks between three dimensional reconstruction images of rotational DSA and those of traditional DSA, outcoming with more angles and data on three dimensional reconstruction images. Conclusions There are more angles of aneurysmal neck can be shown on rotational 3D DSA especially for the demonstration of the largest aneurysmal neck with a directional value for the intervention. (J Intervent Radiol, 2006, 15: 259-260)
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90%) in 57, 70%-90% in 27 cases, 50～70% in 8 cases,
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Objective To evaluate the treatment of spinal cord vascular malformations by endo vascular therapy. Methods All 41 patients including 3 cases were embolized by 3 0 silk line segments, 14 cases by selective embolization of dry dura particles, 16 by PVA and 8 cases by NBCA. Results Lesions were completely embolized in 27 cases, and partialy embolized in 14 cases. Paralysis of limbs were significantly improved in 36 cases, the other 5 cases showed no improvement on account of previous resection of the lesions. During 32 months follow up period, 18 cases recovered completely but with recurrence in 5. Conclusion Endovascular therapy is effective for spinal cord vascular malformations.