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简介：Objective:Todiscussthediagnosisandmanagementoftraumaticcarotidcavernousfistula(TCCF).Methods:Inall15patientswithTCCFconfirmedbyangiography,8patientsgotearlydiagnosisandcure.WithSeldingertechniqueadpotedinthepunctureoffemoralartery,Magic3F-1.8FBDcatheterscombiningwithballoonwereusedtoembolizethefistulaortheinternalcarotidartery.Results:Earlydiagnosisandcurewereachievedin8patientswithinoneweekandnosequelaeoccurred.Sevenpatientswithdelayeddiagnosiswhowerecuredbeyondoneweekhadsomesequelaesuchashypopsiain5cases,incompleteoculomotorparalysesin3andincompleteabducentparalysesin2.Amongallthe15cases,theinternalcarotidarterywaspreservedin12casesacountingfor80%.Occludingthefistulawithsacrificeoftheinternalcarotidarterywasperformedin3casesandnorepatencyofthefistulaoccurredbyfollowingupbeyondthreemonths.Conclusions:ThepreferredtherapyforTCCFistooccludethefistulausingdetachableballoon.ThediagnosisandtreatmentforTCCFcansignificantlyreduceoccurrencerateofthecomplicationsandsequelae.

简介：Amongthevariousdiagnosticmodalitiesforsmallbowelhemangioma,videocapsuleendoscopy(VCE)anddouble-balloonenteroscopy(BE)canberecommendedaspartofthework-upinpatientswithobscuregastrointestinalbleeding(OGIB).BEissuperiortoVCEintheaccuracyofdiagnosisandtherapeuticpotential,whileinmostcasestotalenteroscopycannotbeachievedthroughonlytheantegradeorretrogradeBEprocedures.Astreatmentforsmallbowelbleeding,especiallyspoutbleeding,localizationofthelesionforthedecisionofBEinsertionfacilitatesearlytreatment,suchasendoscopichemostaticclipping,allowingpatientstoavoiduselesstransfusionandtheworseningoftheirdiseaseintolife-threateningstatus.ApplyingendoscopicIndiainkmarkingpriortolaparoscopicsurgicalresectionisaparticularlyusefultechniqueformoreminimallyinvasivetreatment.WereporttwocasesofsmallbowelhemangiomafoundinexaminationsforOGIBthatweretreatedwithcombinationoflaparoscopicandendoscopicmodalities.

简介：Wereportacaseofcapillaryhemangiomsathatinvolvedtheentiremiddleearspace,externalauditorycanal(EAC)andtympanicantrum.Symptomsinthecaseincludedearfullness,hearingloss,otalgiaandotorrhea.Thecasewasmisdiagnosedasrecurrentchronicotitismediawithgranulationpreoperatively.Adiagnosisofcapillaryhemangiomawasestablishedbypostoperativehistologicalexamination.Themanagementofcapillaryhemangiomaofthemiddleearandexternalauditorycanalisdiscussed,withareviewoftheliterature.Becauseofitsvariableandsometimesmisleadingclinicalpresentation,hemangiomacaninitiallybemisdiagnosedasotherlesions.Therefore,ahighindexofsuspicionisnecessaryforearlyandaccuratediagnosis.

简介：AbstractBackground:The Tubridge™ flow diverter (TFD) was recently developed in China; however, its safety and efficacy in treating large cavernous carotid artery aneurysms (LCCAs) are unclear. Our objective was to evaluate the safety and efficacy of the TFD in patients receiving TFDs to treat LCCAs (10-25 mm).Methods:Between June 2013 and May 2014, seven patients with LCCAs were enrolled in our study, and all seven patients underwent TFD implantation combined with coils.Results:Angiographic follow-up images were available for all seven patients at a median of 57.5 ± 16.7 (range, 6-69) months. Seven patients obtained favorable angiographic results defined as O'Kelly-Marotta Scale C and D. Clinical follow-up data were available for all seven patients at a median of 73.32 ± 3.6 (range, 66-78) months. No patients developed new neurological deficits. Six patients achieved a modified Rankin scale score of 0, and diplopia improved in the remaining patient.Conclusions:The results were excellent for the aneurysms treated with TFDs in our patients with LCCAs. TFDs are feasible for the treatment of LCCAs, but a multicenter, controlled clinical trial is needed to evaluate the long-term safety and efficacy of the TFD to treat LCCAs.

简介：Carotid-cavernousfistulas(CCFs)areabnormalarteriovenousanastamosesbetweenthecarotidarteryandthecavernoussinus.Thesefistulasmaybeclassifiedbycause(spontaneousortraumatic),flowvelocity(highorlow),orpathogenesis(directorindirect).

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简介：AbstractBackground:Carotid cavernous fistula is a rare complication that is typically associated with head trauma and skull base fractures. The traumatic bilateral carotid cavernous fistula are significantly rarer.Case presentations:We report a case of a 61-year-old man presenting with unilateral exophthalmos, swollen eyelids, conjunctival congestion, and edema etiologically associated with severe trauma. Thereafter, the patient demonstrated symptoms of contralateral oculomotor nerve injury caused by skull base fracture, such as ptosis of eyelid, dilated pupils, and eye movement disorder, and was diagnosed with bilateral carotid cavernous fistula.Conclusions:The patient recovered after undergoing endovascular embolization of bilateral cavernous sinus fistulas. The patient demonstrated the classic symptoms of an extremely rare condition known as bilateral carotid cavernous fistula, in only one eye. Reporting and analyzing this case will help us elucidate the underlying mechanisms of this disease.

简介：Endovascularembolismtechniquehasbeendemonstratedtobethebestinitialoptionfortreatmentofcarotidcavernousfistula(CCF).SeverallargeseriesreportshaveshownthatmostCCFscanbesuccessfullyoccludedviatransarterialortransvenousendovascularapproach.1-6ThispaperreportsacaseofCCFrecurredafterendovascularocclusionofinternalcarotidartery(ICA)proximaltothefistula.AnewtechniquehasbeendescribedfortransarterialembolizationwithtungstenmicrocoilsviasurgicalexposuretoICA,whichhasnotbeenreportedpreviouslyintheliteratures.

简介：Objective:Toexplorethecausesoftheformationoftraumaticcarotid-cavernousfistulasandthetherapeuticeffectofdetachableballoonand/orcoilembolizationandthepreventionofitscomplications.Methods:FromOctober,1992toMarch,2002,17patientswithtraumaticcarotid-cavernousfistulasweretreatedwithdetachableballoonand/orcoilembolizationinourhospital.TheclinicaldataandimagingfeaturesofCT,MRandselectiveangiogramofthesepatientswereanalyzed.Results:Oneweekaftertreatmentwithembolization,theclinicalsymptomsofthe17patientswereremitted,andopticcacophony,nystagmus,exophthalmosanddropsyofconjunctivadisappeared.Twopatientsmanifestedsurgicalcomplications,onepatientdied.Sixteenpatientssurvived.Theywereallfollowedupformorethan2years,whichshowedonepatienthadhandicapinmovement,andinonepatientthesignsandsymptomsoftraumaticcarotid-cavernousfistulasreoccurred2monthsaftertreatment.Conclusions:Thedetachableballoonand/orcoilembolizationissafeandreliable.Itisagoodmethodtotreattraumaticcarotid-cavernousfistulas.

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简介：瞄准：估计他我在勃起组织ofsildenafil的oxygenase-1(HO-1)活动对待柠檬酸盐的老鼠。方法：192只Sprague-Dawley雄的老鼠，划分了成四个相等的组，被调查。组织1，控制组，收到的常规动物食物；由胃内试管组织2收到的sildenafil柠檬酸盐；组3收到的sildenafiland惊讶禁止者(锌原卟啉，ZnPP)；并且组4收到了sildenafil和氮的oxidesynthase(NOS)禁止者L-nitroarginine甲基酉旨(L名字)。从每个组的12只老鼠在0.5h，1h，2h和药管理的3h以后被打死。然后，在勃起组织的HO-1活动，cGMP层次和NOSenzymatic活动被估计。结果：在勃起组织，HO-1activity，NOS酶的活动和cGMP，集中在整个实验与另外的组相比增加了显著地对待insildenafil的老鼠。收到任何一个HOorNOS禁止者的老鼠在这些参数显示出重要减少。酶的活动表明了的HO-1勃起组织活动和NOS与cGMP层次的积极重要关联(r=0.646，r=0.612分别地；P<0.001)。结论：在勃起组织的PDE_5禁止者sildenafilcitrate的行动部分通过在HO-1和NOS活动之间的相互依赖的关系被调停。

简介：AbstractBackground:The development of carotid-cavernous fistulas (CCFs) during surgical recanalization of chronic internal carotid artery occlusion (ICAO) may be secondary to severe ICA dissection rather than a focal tear of the cavernous ICA seen in typical traumatic CCFs. The purpose of this study is to investigate the causal relationship between the CCFs and severe ICA dissections and to characterize technical outcomes after treatment with stenting.Methods:Five patients underwent treatment with self-expanding stents due to intraprocedural CCF and ICA dissection following surgical removal of ICAO plaque. The stents were telescopically placed via true channel of the dissection. Safety of the procedure was evaluated with 30-day stroke and death rate. Procedural success was determined by the efficacy of CCF obliteration and ICAO recanalization with angiography.Results:All CCFs were associated with spiral and long segmental dissection from the cervical to cavernous ICA. After stenting, successful dissection reconstruction with TICI 3 was achieved in all patients, with complete (n = 4) or partial CCF (n = 1) obliteration. No patient had CCF syndrome, stroke, or death during follow-up of 6 to 37 months; but one patient had pulsatile tinnitus, which resolved 1 year later. Angiography at 6 to 24 months demonstrated CCF obliteration in all 5 patients and durable ICA patency in 4 patients.Conclusions:Intraprocedural CCFs with spiral and cervical-to-cavernous ICA dissection during ICAO surgery are dissection-related because of successful obliteration after stenting for dissection reconstruction. Self-expanding stenting through true channel of the dissection, serving as implanting stent-autograft, may be an optimal therapy for the atypical CCF complication from ICAO surgery.