Endovascular Treatment Of Traumatic Catotid Cavernous Fistulae : Experience In Samaritana Universty Hospital And Rewiew Of The Literature
Autor: | García García, Marco Fabián |
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Přispěvatelé: | Riveros Castillo, William Mauricio |
Jazyk: | Spanish; Castilian |
Rok vydání: | 2017 |
Předmět: | |
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DOI: | 10.48713/10336_14174 |
Popis: | Las fístulas carótido cavernosas (FCC) son conexiones anómalas entre la arteria carótida o ramas meníngeas con el seno cavernoso. Según su origen, Pueden ser divididas en postraumáticas y espontáneas; según su hemodinámica en fístulas de alto o bajo flujo y según su anatomía vascular en directas e indirectas. Las traumáticas son las más frecuentes y resultan de laceración de pared arterial por aceleración desaceleración en caídas o accidente de tránsito, o por lesión directas por armas corto punzantes, arma de fuego o iatrogénicas; las FCC espontáneas son causadas principalmente por aneurismas intracavernosos rotos o enfermedades de pared vascular sistémica. Cuando está asociada a un trauma, la fístula usualmente es una lesión de alto flujo, que produce un distintivo síndrome clínico caracterizado por una proptosis pulsátil, dolor ocular y soplo audible. La clasificación usual es la de Barrow, la cual describe la anatomía radiológica vascular, dividiéndolas en fístulas tipo A que se caracterizan por comunicación directa entre la carótida interna y el seno cavernoso; en las tipo B existe comunicación entre ramas meníngeas de la arteria carótida interna y el seno cavernoso; en las tipo C donde hay comunicación entre ramas meníngeas de la arteria carótida externa y el seno cavernoso, y en las tipo D que presentan comunicación entre ramas meníngeas de las arterias carótidas interna y externa y el seno cavernoso. Para el tratamiento, la mayoría de estas lesiones son manejadas por técnicas endovasculares, teniendo en cuenta que puede ser por vía transarterial y la transvenosa dependiendo de la anatomía de la fístula. Se utilizan técnicas de liberación espiral con coils, se describen técnicas con onyx y con la ayuda de stent para controlar el flujo arterial. Presentamos la experiencia en nuestra institución del manejo endovascular de fístulas carótido - cavernosas y la revisión de la literatura. Carotid cavernous fistula (CCF) are an anomalous connections between the carotid artery or one of the meningeal branches to the cavernous sinus. According to their origin, they can be divided into traumatic and spontaneous; by their characteristics, in high or low flow, and their vascular anatomy by direct and indirect. Traumatic are the most common and result from laceration of arterial Wall, acceleration or deceleration in fall accident, or by direct stab weapon, firearm or iatrogenic injury; CCF spontaneous are mainly caused by intracavernous aneurysms or systemic vascular diseases wall. When is associated with trauma, fistulas are usually high flow lesions, which produces a distinctive clinical syndrome characterized by a pulsating proptosis, eye pain and audible murmur. The usual classification is Barrow, which describes the vascular radiological anatomy, dividing them into fistulas type A characterized by direct communication between the internal carotid artery and the cavernous sinus; in type B communication exists between meningeal branches of the internal carotid artery and the cavernous sinus; in type C where communication between meningeal branches of the external carotid artery and the cavernous sinus, and the D type having communication between meningeal branches of the internal and external carotid artery and the cavernous sinus. For treatment, the majority of these injuries are managed by endovascular techniques, taking into account that can be transarterial and transvenous approach, its depending on the anatomy of the fistula. Release techniques spiral hidrocoils are used, techniques are described onyx and with the help of the stent to control blood flow. We present our experience in management institution of endovascular carotid cavernous fistulas and literature review. |
Databáze: | OpenAIRE |
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