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KMID : 0378119890160020542
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Chungnam Medical Journal
1989 Volume.16 No. 2 p.542 ~ p.548
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Treatment of Traumatic Carotid-Cavernous Fistulas Using Debrun Detachable Balloons
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Abstract
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The occlusion of fistula was done using detachable balloons in six cases of traumatic carotid-cavernous fistulas(CCF) and the results of the experience are reported.
Transarterial approach was tried in all 6 cases using manually-tied Debrun latex balloons, one in four cases and two in two cases. Balloon embolization improved visual acuity in 3 cases among 4 cases of decreased visual acuity, and light reflex in 3 cases among 4 cases of decreased or abscent light reflex.
Stenosis of ICA at the fistular orifice was made in 2 cases(case 3； 20％, case 4； 70％) without clinical symptoms. Ten-month follow-up angiogram of case 4 showed complete shrinkage of the balloon and change of the stenotic ICA to normal diameter. Minor complications such as nausea, vomiting, and ocular pain were present in all cases which completely disappeared in one week.
Balloon embolization is the definitely effective treatment of post-traumatic CCF, which should be done by experienced radiologists. Early diagnosis and early treatment should be made to improve the reversible visual loss and cranial nerve palsy before the irreversible complication may occur.
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