Balloon Catheterによる頸動脈海綿静脈洞瘻の治療

The Use of Balloon Catheters in The Treatment of Carotid Cavernous Sinus Fistula

　近年のinterventiollal neuroradlologyの進歩は，従来議論のあった頸動脈海綿書静脈洞瘻（CCF）に対する治療法の1つとして注目されている，

　今回11例のCCF（外傷性7例，特発性4例）に対し，Fogartycatheterと1）ebrunのdetachable balloonによる治療を試みた．Fogarty catheterによるintracarotid occluslonを施1書fした症例は8例で，うち外傷性の4例全例に，特発性では4例中1例に症状の改善を認めた書しかし外傷性の1例で術後balloonのoverinflationによる外転神経麻痺を，特発性の1例で脳梗塞，2例に術後の血管写でfistulaの残存を認めた．Debrunのdetachable balloonを用いた外傷性の3例中2例で内頸動脈の血流を維持し，かつfistulaの閉塞に成功した．1例は術中balloonのpremature ruptureにより閉塞に失敗した．

　The carotid cavernous sinus fistula (CCF) isone of the difficult neurosurgical problems. Itstreatment has changed frequently since the firstattempt in 1809¹⁸⁾. The early treatment of CCFevolved considerably following Travers' reportof the ligation the common carotid artery¹⁸⁾. Since 1930, when Brooks³⁾ first introduced theintravascular embolization technique for CCF, interventional neuroradiology has been one ofthe technical developments which permits effec—tive intravascular treatment. In 1971, Prolo andHanbery¹⁴⁾ first reported the successful use ofa Fogarty balloon catheter to treat CCF. ThenSerbinenko¹⁶⁾ and later Debrun et al^5,6) described a detachable balloon technique to obliterate fistulae with the preservation of carotidblood flow.

　This paper presents our clinical experiencewith the balloon treatment for CCF.