Zhang Jinwei,Wu Shuihua,Chen Zhaohui,et al.Interventional embolization for pediatric carotid-cavernous sinus fistula[J].Journal of Clinical Pediatric Surgery,,():772-776.[doi:10.3760/cma.j.cn101785-202301006-013]
Interventional embolization for pediatric carotid-cavernous sinus fistula
- Abstract:
- Objective To explore the efficacy and interventional treatment strategies of embolization for pediatric carotid-cavernous sinus fistula (CCF).Methods A retrospective analysis was conducted on the clinical data of a pediatric patient with CCF who successfully underwent interventional embolization in May 2022 at the Department of Neurosurgery,Hunan Children’s Hospital.Relevant literature from 1980 to 2022 was retrieved from PubMed and Embase using the search term "carotid-cavernous sinus fistula in children; embolization operation" and from Chinese databases including Wanfang Medical Network,CNKI,and the Chinese Biomedical Literature Service System using the search terms "pediatric carotid-cavernous sinus fistula,interventional embolization surgery".The clinical symptoms,disease types,treatment plans,and outcomes of this case and those reported in previous literature were summarized and analyzed.Results 6 relevant articles on pediatric CCF were found,reporting a total of 6 cases.Including the present case,7 cases were analyzed.Of these 7 cases,6 were males and 1 was female,with ages ranging from 1 month and 21 days to 9 years and 2 months,with an average age of 5.87 years.All presented with ocular symptoms such as exophthalmos,ocular motility disorder,and ptosis.5 cases were traumatic CCF,and 2 were spontaneous CCF.All were treated with interventional embolization.One patient died,while 6 survived.During the follow-up period of 1 to 12 months,symptoms such as ptosis and exophthalmos disappeared in the 6 surviving patients,and normal eye movement was restored.Conclusions Carotid-cavernous sinus sinus fistula is rare in children.Interventional embolization provides a new life-saving treatment method for this condition.
References:
[1] 王跃飞,祝源,孟亮,等.复合技术治疗颈内动脉海绵窦段巨大动脉瘤破裂致颈动脉海绵窦瘘一例[J].中国脑血管病杂志,2022,19(7):490-493.DOI:10.3969/j.issn.1672-5921.2022.07.008. Wang YF,Zhu Y,Meng L,et al.Compound technology treatment for carotid-cavernous fistula caused by ruptured giant carotid artery aneurysm:a case report[J].Chin J Cerebrovasc Dis,2022,19(7):490-493.DOI:10.3969/j.issn.1672-5921.2022.07.008.
[2] 罗叶芳,何为民.首诊于眼科的颈动脉海绵窦瘘36例临床分析[J].临床眼科杂志,2022,30(3):225-229.DOI:10.3969/j.issn.1006-8422.2022.03.007. Luo YF,He WM.Clinical analysis of 36 cases firstly diagnosed in ophthalmology department with carotid cavernous fistula[J].J Clin Ophthalmol,2022,30(3):225-229.DOI:10.3969/j.issn.1006-8422.2022.03.007.
[3] 金洪泽,吕中华,刘伟,等.创伤性颈动脉海绵窦瘘合并假性动脉瘤和大脑中动脉闭塞一例[J].中华神经外科杂志,2022,38(1):99-100.DOI:10.3760/cma.j.cn112050-20210401-00159. Jin HZ,Lyu ZH,Liu W,et al.A case of traumatic carotid cavernous sinus fistula combined with pseudoaneurysm and middle cerebral artery occlusion[J].Chin J Neurosurg,2022,38(1):99-100.DOI:10.3760/cma.j.cn112050-20210401-00159.
[4] 朱灿敏,张细六,李强,等.以单纯急性视力下降为临床表现的自发性颈内动脉海绵窦瘘一例[J].中华全科医师杂志,2020,19(8):741-742.DOI:10.3760/cma.j.cn114798-20191126-00851. Zhu CM,Zhang XL,Li Q,et al.Spontaneous carotid cavernous fistula with acute visual loss as clinical manifestation in an elderly patient[J].Chin J Gen Pract,2020,19(8):741-742.DOI:10.3760/cma.j.cn114798-20191126-00851.
[5] 夭志刚,周念,严兵,等.介入栓塞联合开放手术治疗外伤后儿童肾恶性横纹肌样瘤破裂1例[J].临床小儿外科杂志,2022,21(7):692-694.DOI:10.3760/cma.j.cn101785-202002060-019. Yao ZG,Zhou N,Yan B,et al.Interventional embolization plus open surgery in the treatment of traumatic rupture of malignant rhabdoid tumor of kidney in children:one case report[J].DOI:10.3760/cma.j.cn101785-202002060-019.
[6] 王大宝,张霞,胡炜.介入栓塞术及颅内夹闭术对动脉瘤性蛛网膜下腔出血的影响[J].医学研究杂志,2022,51(9):89-92.DOI:10.11969/j.issn.1673-548X.2022.09.019. Wang DB,Zhang X,Hu W.Effects of interventional embolization and intracranial clipping on aneurysmal subarachnoid hemorrhage[J].J Med Res,2022,51(9):89-92.DOI:10.11969/j.issn.1673-548X.2022.09.019.
[7] Morais BA,Yamaki VN,Caldas JGMP,et al.Post-traumatic carotid-cavernous fistula in a pediatric patient:a case-based literature review[J].Childs Nerv Syst,2018,34(3):577-580.DOI:10.1007/s00381-017-3668-7.
[8] Wajima D,Nakagawa I,Park HS,et al.Successful coil embolization of pediatric carotid cavernous fistula due to ruptured posttraumatic giant internal carotid artery aneurysm[J].World Neurosurg,2017,98:871.e23-871.e28.DOI:10.1016/j.wneu.2016.11.137.
[9] Pang D,Kerber C,Biglan AW,et al.External carotid-cavernous fistula in infancy:case report and review of the literature[J].Neurosurgery,1981,8(2):212-218.DOI:10.1227/00006123-198102000-00011.
[10] Lin CJ,Luo CB,Chang FC,et al.Combined transarterial,transvenous,and direct puncture of the cavernous sinus to cure a traumatic carotid cavernous fistula[J].J Clin Neurosci,2009,16(12):1663-1665.DOI:10.1016/j.jocn.2009.02.026.
[11] Yu JL,Guo YB,Wu ZX,et al.Traumatic arteriovenous fistula between the extracranial middle meningeal artery and the pterygoid plexus:a case report and literature review[J].Interv Neuroradiol,2017,23(1):90-96.DOI:10.1177/1591019916673584.
[12] 凌峻,杨少春,邱传珍,等.儿童外伤性颈内动脉动脉瘤伴双侧颈内动脉海绵窦瘘一例并文献复习[J].赣南医学院学报,2018,38(4):395-397,399.DOI:10.3969/j.issn.1001-5779.2018.04.024. Ling J,Yang SC,Qiu CZ,et al.Traumatic intracranial aneurysm and cavernous fistula in children:a report of 1 case and literature review[J].J Gannan Med Univ,2018,38(4):395-397,399.DOI:10.3969/j.issn.1001-5779.2018.04.024.
[13] 黄芳,国宁.颈内动脉海绵窦瘘50例围术期综合护理[J].齐鲁护理杂志,2014,20(14):63-64.DOI:10.3969/j.issn.1006-7256.2014.14.029. Huang F,Guo N.Comprehensive perioperative care for 50 cases of internal carotid artery cavernous sinus fistula[J].J Qilu Nurs,2014,20(14):63-64.DOI:10.3969/j.issn.1006-7256.2014.14.029.
[14] 李桂林,王斌,高俊,等.表现为脑神经麻痹的自发性颈内动脉海绵窦瘘1例[J].中国微侵袭神经外科杂志,2008,13(11):525. Li GL,Wang B,Gao J,et al.A case of spontaneous cavernous sinus fistula of the internal carotid artery presenting as cerebral nerve palsy[J].Chin J Minim Invasive Neurosurg,2008,13(11):525.
[15] Barrow DL,Spector RH,Braun IF,et al.Classification and treatment of spontaneous carotid-cavernous sinus fistulas[J].J Neurosurg,1985,62(2):248-256.DOI:10.3171/jns.1985.62.2.0248.
[16] Sumdani H,Aguilar-Salinas P,Avila MJ,et al.Carotid cavernous fistula treatment via flow diversion:a systematic review of the literature[J].World Neurosurg,2021,149:e369-e377.DOI:10.1016/j.wneu.2021.02.015.
[17] Al Saiegh F,Velagapudi L,Jabbour P.Transvenous Onyx embolization of a type D carotid-cavernous-fistula:operative video[J].World Neurosurg,2021,156:11.DOI:10.1016/j.wneu.2021.08.107.
[18] 赵旺淼,葛春燕,张万增,等.动静脉联合入路Onyx胶栓塞创伤性颈动脉海绵窦瘘术中大量鼻出血一例[J].中华创伤杂志,2020,36(11):1054-1056.DOI:10.3760/cma.j.cn501098-20200716-00507. Zhao WM,Ge CY,Zhang WZ,et al.A case of massive rhinorrhage during traumatic carotid cavernous sinus fistula embolisation by combined arteriovenous approach with Onyx gel[J].Chin J Trauma,2020,36(11):1054-1056.DOI:10.3760/cma.j.cn501098-20200716-00507.
[19] 吴亮,冯大勤,周传凯,等.双球囊技术在外伤性颈动脉海绵窦瘘治疗中应用探讨[J].介入放射学杂志,2021,30(9):866-869.DOI:10.3969/j.issn.1008-794X.2021.09.002. Wu L,Feng DQ,Zhou CK,et al.Discussion on the application of dual-balloon technique in treating traumatic carotid-cavernous fistula[J].J Interv Radiol,2021,30(9):866-869.DOI:10.3969/j.issn.1008-794X.2021.09.002.
[20] Gu J,Yan M,Fan WJ,et al.Transvenous embolization of carotid cavernous fistula through inferior petrosal sinus with detachable coils and ethylene vinyl alcohol copolymer[J].J Vis Exp,2020,(159):e59435.DOI:10.3791/59435.
Memo
收稿日期:2023-1-9。
通讯作者:吴水华,Email:292454021@qq.com