Diagnosis and treatment of traumatic carotid cavernous fistula / 中华创伤杂志(英文版)

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the diagnosis and management of traumatic carotid cavernous fistula (TCCF).</p><p><b>METHODS</b>In all 15 patients with TCCF confirmed by angiography, 8 patients got early diagnosis and cure. With Seldinger technique adopted in the puncture of femoral artery, Magic 3 F-1.8 F BD catheters combining with balloon were used to embolize the fistula or the internal carotid artery.</p><p><b>RESULTS</b>Early diagnosis and cure were achieved in 8 patients within one week and no sequelae occurred. Seven patients with delayed diagnosis who were cured beyond one week had some sequelae such as hypopsia in 5 cases, incomplete oculomotor paralyses in 3 and incomplete abducent paralyses in 2. Among all the 15 cases, the internal carotid artery was preserved in 12 cases accounting for 80%. Occluding the fistula with sacrifice of the internal carotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.</p><p><b>CONCLUSIONS</b>The preferred therapy for TCCF is to occlude the fistula using detachable balloon. The diagnosis and treatment for TCCF can significantly reduce occurrence rate of the complications and sequelae.</p>