Application of the Willis Covered Stent in the Treatment of Carotid–Cavernous Fistula: A Single-Center Experience
| Autor: | Chaohua Wang, Xiao-Dong Xie, Jaims Lim, Ting Wang, Liangxue Zhou, Cong Wu, Sen Lin, Lun-Xin Liu, Changwei Zhang |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male China medicine.medical_specialty Adolescent medicine.medical_treatment Fistula Balloon Single Center Young Adult 03 medical and health sciences Carotid-Cavernous Sinus Fistula 0302 clinical medicine medicine.artery medicine Humans Carotid-cavernous fistula business.industry Endovascular Procedures Stent Perioperative Middle Aged medicine.disease Blood Vessel Prosthesis Surgery Stenosis Treatment Outcome 030220 oncology & carcinogenesis Female Stents Neurology (clinical) Internal carotid artery business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | World Neurosurgery. 122:e390-e398 |
| ISSN: | 1878-8750 |
| Popis: | Background The purpose of the present study was to describe our single-institutional experience of treating direct carotid–cavernous fistulas (DCCFs) with Willis covered stents (WCSs). Methods Of a total of 31 DCCFs, 10 were treated with WCSs (Microport, Shanghai, China) at West China Hospital from January 2015 to December 2016. The indications for treatment, perioperative findings, and postoperative and follow-up results were collected and analyzed. Results All 10 patients had successful deployment of WCSs. Complete exclusion of the fistula was achieved in 6 patients immediately after deployment of 1 stent. Endoleak was observed in 4 patients (patients 2, 4, 5, and 9). Thus, repeat dilation of the stent with greater pressure was performed, which resolved the endoleak in 2 patients (patients 2 and 9). The endoleak of the other 2 patients persisted after repeat dilation of the balloon. Hence, a second stent was deployed in these 2 patients (patients 4 and 5), which eliminated the endoleak in patient 4. However, patient 5 continued to have a minimal endoleak. Nine patients had fistulas successfully occluded by WCSs during the follow-up period. One patient experienced recurrence of a DCCF at the 10-day follow-up point. We chose coil embolization to address this DCCF. No stenosis of the internal carotid artery or DCCF recurrence, except that in the abovementioned patient, was observed. Conclusions WCS was proved to be an alternative treatment method for complex DCCFs through reconstruction and preservation of the internal carotid artery. Our study also confirmed the safety, efficacy, and midterm durability of WCSs for complex DCCFs without any serious delayed complications. |
| Databáze: | OpenAIRE |
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