Treatment of traumatic carotid cavernous fistula by endovascular embolization and the cure and prevention of its complications

Objective To explore the treatment of traumatic carotid cavernous fistula(TCCF) by endovascular embolization and its curative efficacy.Methods Among 56 patients with TCCF,54 cases were embolized by puncture via femoral route and 2 cases via the femoral vein and superior petrous vein route.For the embolization materials,balloons were used in 49 cases,microcoils were used in 2 cases,and both two materials in 5 cases.Results The fistulae of 49 cases were occluded with the patency of parent arteries and internal carotid artery(ICA).Both fistulae and ICA were occlued in 7 cases.The rate of ICA patency was 87.5%.No dead case due to surgical treatment.The total success rate was 100%.None of the carotid cavernous fistula recurred during the follow-up from 4 months to 12 years.The symptoms and signs of all patients disappeared remarkably except for 1 case of eyesight perpetual ablepsia after the embolization.No cerebral ischemia and infarction occurred during the follow-up.Conclusion The endovascular embolization by artery route has become the most effective method for the treatment of TCCF,but detachable balloon should be the first choice.For small fistula,microcoil embolization is a better choice.The results of endovascular embolization are reliable for the treatment of TCCF.