Surgery Trapping Of Refractory Traumatic Carotid-cavernous Fistulae And Iatrogenic Internal Carotid Artery Laceration

Endovascular embolism treatment is the first select approach forTraumatic carotid-cavernous fistula (TCCF)at present.Balloonembolism and coils technique almost may solve all problems.Traditional surgery treatment already was abandoned nearly at somedeveloped economy area microsurgery center. However, surgerytrapping treatment demonstrates invariably clinical value for someTraumatic carotid-cavernous fistula which is failure to endovasculartreatment and iatrogenic internal carotid artery laceration. FromSeptember 2003 to December 2005, Our hospital adopted surgerytrapping to treate 10 cases of traumatic carotid-cavernous fistulawhich is failure with endovascular treatment and 1 case of pituitarytumor extraction complicating internal carotid artery cavernous sinussection laceration. Objective: To investigate the preoperative preparation andtreatment effect of surgery trapping for refractory CCF and iatrogenicinternal carotid artery laceration. Methods: To study retrospectively the ten patients (man, 7;woman, 3;mean age, 36 years) with refractory shuts and onepatient(woman;age, 52 years) with iatrogenic internal carotid arterylaceration were treated by using surgery trapping at our hospitolbetween September 2003 and December 2005. Results: Ten patients suffered from traumatic carotid cavernousfistula and one patient of pituitary tumor extraction with undergointernal carotid artery cavernous sinus section laceration receivedsurgery trapping. Satisfactory recovery in 8cases (80.0%), 2 caseswere mild disabled (20.0%), without death case. All patients weresuccessfully treated by surgery trapping, A follow-up of 11 patientsfor 3 months to 2 years revealed satisfactory recovery. No notableprocedure-related complication was observed in these patients.Conclusion: Surgery Trapping of refractory CCF should be asafe and effective method. Surgery trapping is the important pathwayto cure iatrogenic internal carotid artery cavernous sinus sectionruptured, remove the tumour while trapping the ruptured split.