rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2020-101-5-283-287rentrad-591Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHРезультаты эндоваскулярного лечения прямых высокопотоковых каротидно-кавернозных соустийResults of Endovascular Treatment for High-Flow Direct Carotid-Cavernous Fistulashttps://orcid.org/0000-0002-3112-6584ПетровА. Е.PetrovA. E.

Петров Андрей Евгеньевич - кандидат медицинских наук, заведующий нейрохирургическим отделением № 3.

Ул. Маяковского, 12, Санкт-Петербург, 191014

Andrey E. Petrov - Cand. Med. Sc., Head of Department.

Ul. Mayakovskogo, 12, Saint-Petersburg, 191014

https://orcid.org/0000-0001-7297-3213ГорощенкоС. А.GoroshchenkoS. А.

Горощенко Сергей Анатольевич - кандидат медицинских наук, врач-нейрохирург.

Ул. Маяковского, 12, Санкт-Петербург, 191014

Andrey E. Petrov - Cand. Med. Sc., Head of Department.

Ul. Mayakovskogo, 12, Saint-Petersburg, 191014

goroschenkos@gmail.comhttps://orcid.org/0000-0002-0974-460XРожченкоЛ. В.RozhchenkoL. V.

Рожченко Лариса Витальевна - кандидат медицинских наук, врач-нейрохирург.

Ул. Маяковского, 12, Санкт-Петербург, 191014

Andrey E. Petrov - Cand. Med. Sc., Head of Department.

Ul. Mayakovskogo, 12, Saint-Petersburg, 191014

https://orcid.org/0000-0003-0350-0249СамочерныхК. А.SamochernykhK. A.

Самочерных Константин Александрович - доктор медицинских наук, заместитель директора по научной и лечебной работе.

Ул. Маяковского, 12, Санкт-Петербург, 191014

Andrey E. Petrov - Cand. Med. Sc., Head of Department.

Ul. Mayakovskogo, 12, Saint-Petersburg, 191014

Российский научно-исследовательский нейрохирургический институт им. проф. А.Л. Поленова -филиал ФГБУ Национальный медицинский исследовательский центр им. В.А. Алмазова Минздрава РоссииРоссияPolenov Russian Scienific Research Institute of Neurosurgery - Branch of Almazov National Medical Research Centre, Ministry of Health of the Russian FederationRussian Federation2020171120201015283287Copyright © Петров А.Е., Горощенко С.А., Рожченко Л.В., Самочерных К.А., 20202020Петров А.Е., Горощенко С.А., Рожченко Л.В., Самочерных К.А.Petrov A.E., Goroshchenko S.А., Rozhchenko L.V., Samochernykh K.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/591Цель

Цель: изучение результатов эндоваскулярного лечения пациентов с прямыми высокопотоковыми каротидно-кавернозными соустьями путем их трансартериальной окклюзии с помощью отделяемых баллонов и микроспиралей.

Материал и методы

Материал и методы. Оперированы 35 пациентов с применением отделяемых баллонов и микроспиралей. Клиническая картина у всех больных была представлена пульсирующим экзофтальмом, птозом на стороне поражения, офтальмоплегией и хемозом конъюнктивы.

Результаты

Результаты. У всех больных после первичной операции достигнуто выключение каротидно-кавернозных соустий и регресс симптоматики. После применения микроспиралей добиться реконструкции внутренней сонной артерии удавалось достоверно чаще, чем после использования баллонов. Рецидив соустья достоверно чаще встречался у пациентов, оперированных с применением баллонов.

Заключение

Заключение. Лечение при помощи микроспиралей позволяет выполнять успешную реконструктивную операцию достоверно чаще, частота рецидивов при этом значительно ниже, чем после применения баллонов.

Objective

Objective: to study the results of treatment in patients with direct high-flow carotid-cavernous fistulas with their transarterial occlusion using detachable balloons and microcoils.

Material and methods

Material and methods. Thirty-five patients underwent surgery using detachable balloons and microcoils. The clinical picture in all patients was represented by pulsating exophthalmos, ptosis on the side of the lesion, ophthalmoplegia, and conjunctival chemosis.

Results

Results. In all patients closure of carotid-cavernous fistulas and reversal of symptoms were achieved after primary surgery. Internal carotid artery reconstruction with microcoils could be achieved significantly more often than that with balloons. An anastomotic recurrence was significantly more common in patients undergoing surgery with balloons.

Conclusion

Conclusion. The use of microcoils allows to perform reconstructive surgery significantly more frequently, while the recurrence rate is significantly lower than after using the balloons.

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The authors declare that there are no conflicts of interest present.