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《Chinese Journal of Neuromedicine》 2006-01
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Treatment of bilateral traumatic carotid cavernous fistulae with endovascular covered stent deployment

HU Jin-qing, LIN Dong, SHEN Jian-kang, WANG Yi. Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University, Shanghai 200025, China  
Objective To report a patient with bilateral traumatic carotid cavernous fistulae (TCCF) who was successfully treated with endovascular covered stent deployment. Methods A 58-year-old male patient with severe head injury presented with pulsatile exophthalmos and bruit. The cerebral angiogram revealed bilateral TCCF. The preservation of ICA in bilateral TCCF patient is very important, so we decided to use coverd stents to occlude the fistulae. After receiving antiplatelet drugs for 3 d, the patient underwent bilateral covered stent implantation by endovascular approach under the general anesthesia. Results The bilateral TCCF were successfully treated by endovascular deployment of expandable coronary PTFE-covered stents (Jostent GraftMaster covered stents 3.5 mm×12 mm and 3.5 mm×16 mm) in bilateral ICA. The angiogram immediately after the intervention revealed obliteration of bilateral TCCF and both ICAs were fully patent. The bruit disappeared immediately after covered stent implantation and the chemosis of both eyes disappeared several days later. No complications related with the endovascular therapy were observed. Conclusion Covered stent implantation is an alternative method for TCCF, especially suitable for the patient whose ICA is cannot be preserved by detachable balloon or the patient who cannot tolerate the ICA occlusion.
【CateGory Index】: R651.1
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