Endovscular Treatment And Follow-up Analysis For Traumatic Carotid-cavernous Fistula

Objective Analyse the influential factors for the disease and prognosis condition according to the results of the clinical diagnosis ,the treatment and the follow-up study of traumatic carotid-cavernous fistula (TCCF) .Methods 27 patients of TCCF in the first affiliated hospital of Xinjiang Medical University who were treated by endovscular embolization from October 2002 to January 2008 were analyzed retrospectively. The follow-up study of the 27 cases was collected to investigate the patients′prognosis by out-patient clinical recheck, calls,letters and E-mails etc. Analyse the factors which affect therapy and prognosis by using logistic regression.Results 27 TCCF patients included, we can finally diagnose the disease by checking the clinical syptoms, consulting one or two imaging examinations and DSA examination. All of them are embolized by detachable balloons. The achievement rate of the first embolization is 96.3% (26/27).1 case recured for the balloon divulged but suceessfully treated by endovascular approach again. After operations the symptoms of pulsating exophthalmos, congested , edema conjunctiva and intracal bruit disappeared in a week. After the follow-up study between 4 months and 53months and through statistics analysis on the final results, we found the recovery of the patients` ocular symptoms may be effected by the interval from being injured to the appearance of symptoms, the interval from the appearance of initial symptom to the diagnosis, and the number of the detachable balloons; the recovery of visual sight may be effected by the interval from the appearance of initial symptom to the diagnosis, which are the key factors concerned with the prognose.Conclusion Make the diagnosis on the craniocerebral trauma patients to see if they show the symptoms of pulsating exophthalmos, congested and edema conjunctiva, intracranial bruit, and consulting one or more imaging examinations can be helpful to the early diagnosis. The final diagnosis should consider DSA examination as the〝golden standard〞for TCCF. Endovascular treatment is now considered as the most ideal approach with the advantages that other treatments cannot substitute. Finally through the analysis of the follow-up study and statistics analysis, we found the appearance of initial symptom to the diagnosis,the appearance of initial symptom to the diagnosis and the number of effected are embolized balloons the prognosis was effected by age, interval from the appearance of initial symptoms to the diagnosis and the number of embolized balloons will affect the recovery of clinical symptoms. Through the logistic regression analysis, we found the prognosis was effected by the appearance of initial symptoms to the diagnosis,and it is one of the risk factors for the disease. So timely diagnosis and scientific treatment of this disease make a great sense to improve the prognosis for TCCF patients.