[Application of endovascular covered stent for treating vertebral dissecting aneurysm and carotid-cavernous fistula].

OBJECTIVE

To investigate the therapeutic effects of endovascular covered stent on vertebral dissecting aneurysm and carotid-cavernous fistula (CCF).

METHODS

From March 2006 to May 2007, Jostent coronary stent grafts were used to treat 4 patients with vertebral dissecting aneurysm and 3 patients with CCF. The patients of vertebral dissecting aneurysm were male and 37- 57-years-old, the lesion was located on the left vertebral artery in 3 patients and on the right vertebral artery in 1 patient, with the primary symptoms of sudden headache and vomiting; CT scan demonstrated subarachnoid hemorrhage; and the medical history varied from 2 days to 10 years. The patients of CCF were male and 35- 51-years-old, the lesion was located on the left carotid artery in 2 patients and on the right carotid artery in 1 patient, with the primary symptoms of headache, lateral exophthalmos, eyeball distending pain, conjunctive hyperemia and impaired eyesight; all 3 patients got head injury 2 days to 1 month before the appearance of symptoms and 1 of them had a history of severe nosebleed; and the medical history ranged from 1 week to 2 months.

RESULTS

For the patients with vertebral dissecting aneurysm, complete obliteration of aneurysms was achieved, the circulations of the vertebral artery, the adjacent posterior inferior cerebellar artery and the adjacent anterior inferior cerebellar artery were smooth, no complications relative to operation occurred, and no recurrence of symptoms and intracranial rehaemorrhagia were observed during the follow-up period of 8 months-2 years. For the patients with CCF, the fistula were completely obliterated, the circulation of carotid artery was smooth, the exophthalmus and conjunctiva hyperemia were improved obviously 3 days after operation, the eyesight of patient was improved at different levels over the follow-up period of 1-3 months.

CONCLUSION

Endovascular covered stent is a new and useful tool for the treatment of vertebral dissecting aneurysm and CCF.