Clinical features of direct carotid cavernous fistulas: comparison with indirect carotid cavernous fistulas
10.3760/cma.j.issn.1673-4165.2021.01.004
- VernacularTitle:直接型颈动脉海绵窦瘘的临床特征：与间接型颈动脉海绵窦瘘的比较
- Author:
Wenjing SONG
;
Li LU
;
Hao CHEN
;
Wei ZHANG
;
Jie ZU
;
Lei BAO
;
Kun ZAN
;
Guiyun CUI
- From:
International Journal of Cerebrovascular Diseases
2021;29(1):18-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features of direct and indirect carotid cavernous fistulas (CCFs).Methods:Patients with CCF treated in the Affiliated Hospital of Xuzhou Medical University from January 2010 to August 2020 were enrolled retrospectively. Relevant clinical data were collected, including the main clinical manifestations, neuroimaging features, and treatment methods. The clinical features of direct and indirect CCFs were compared.Results:A total of 31 patients were enrolled in the study, 29 (93.5%) had ocular symptoms, of which conjunctival hyperemia and edema ( n=24, 77.4%), exophthalmos ( n=19, 61.3%) and orbital murmur ( n=18, 58.1%) were most common. There were 23 patients (74.2%) in direct CCF group and 8 (25.8%) in indirect CCF group. The former had more history of head trauma (78.2% vs. 12.5%; P=0.002), more flow volume (high-flow CCFs: 100% vs. 37.5%; P<0.001) and more likely to cause orbital murmur (69.6% vs. 25.0%; P=0.043). Endovascular embolization was safe and effective. The common methods of endovascular embolization were EVAL glue combined with coil embolization ( n=18, 66.7%) and detachable balloon embolization alone ( n=6, 22.2%). Conclusion:Ocular manifestations are most prominent in patients with CCFs. Direct CCF is more common, usually with a history of head trauma, and the clinical and imaging features are more typical. Interventional embolization is the preferred treatment option for patients with CCF.
