橈骨動脈バイパスを経由した塞栓術を行った外傷性内頚動脈海綿静脈洞瘻の1例

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タイトル別名
  • Trans-radial artery graft bypass embolization for traumatic carotid-cavernous fistula: case report
  • ショウレイ ホウコク トウコツ ドウミャク バイパス オ ケイユ シタ ソクセンジュツ オ オコナッタ ガイショウセイ ナイ ケイドウミャク カイメン ジョウミャクドウロウ ノ 1レイ

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Objective: We report a case of traumatic carotid-cavernous fistula treated with a combination of endovascular therapy and direct surgery.<br>Case presentation: A 24-year-old man presented with blurred vision and diplopia 6 years after a traffic accident. Cerebral angiography revealed a right carotid cavernous fistula with dilated cavernous sinus. After initial transarterial embolization of the cavernous sinus and internal carotid artery, a residual shunt was detected at the distal end of the coil mass. To reduce hemodynamic stress in the sacrificed internal carotid artery, we performed extracranial-intracranial high-flow bypass using a radial artery graft, and direct trapping of the internal carotid artery between the cervical bifurcation and the immediately proximal portion of the ophthalmic artery. However, a residual shunt from the distal end of the clip remained. Coil embolization of the fistula via radial artery graft occluded the residual shunt completely.<br>Conclusion: Endovascular treatment via radial artery graft is a safe and valuable alternative when the primary access route is eliminated.

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 6 (3), 189-195, 2012

    特定非営利活動法人 日本脳神経血管内治療学会

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