Interlocking detachable coilを用いて治療したCCFの1例

A case report of the carotid cavernous fistula treated by endovascular embolization using Interlocking Detachable Coil (IDC)

I．はじめに

　外傷性頸動脈海綿静脈洞瘻（carotid cavernous fistula；CCF）に対する治療は，detachable ballonを用いて動静脈瘻を閉鎖する血管内手術が一般的によく用いられる^2-4,8,9）．しかしながらdetachable balloonの操作性は完全なものではない．そこで今回われわれはより操作性の優れたInterlocking Detachable Coil（IDC）（Target Therapeutics Inc，CA，USA）を用いて塞栓術を行った．その結果が良好であったので報告する．

To treat a carotid cavernous fistula, endovascular embolization using a detachable balloon technique is generally performed to close the fistula. However, the balloon sometimes becomes detached accidentally be-fore reaching the orifice, so it is not an ideal device for closing a fistula from point of view of safety. This time, we performed transarterial endovascular embolizationusing Interlocking Detachable Coils (IDC) for a symp-tomatic CCF, and obtained a good result.

A 32-year-old male, who was injured in a traffic acci-dent developed symptoms of CCF after four months: edema and pain in the right conjunctiva, bruit at the right orbit. Angiography showed CCF, the orifice of which was located at the transitional portion of C4 and C5. IDC embolization was performed; three IDCs were Placed at the cavity of the fitula through the orifice, placed at the cavity of the fistula throug_the orfice, and complete occlusion of the fistula was confirmed on angiography. Postoperative clinical course was good and symptoms were improved.