LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BẰNG CAN THIỆP NỘI MẠCH THÔNG ĐỘNG MẠCH CẢNH XOANG HANG THỂ TRỰC TIẾP TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: To describe the clinical features of direct carotid-cavernous fistula at Hanoi Medical University Hospital and to evaluate the outcomes of endovascular intervention in these patients. Subjects and Methods: A retrospective descriptive study on 18 patients with direct carotid-cavernous fistula who underwent endovascular intervention from January 2021 to February 2025. Results: The average age of the patients was 45.17 ± 15.91 years, with males accounting for 72.2%. Among them, patients with a history of traumatic brain injury accounted for 88.9%. Common symptoms included: headache (100.0%), conjunctival congestion (88.9%), proptosis (77.8%), tinnitus (61.1%), oculomotor palsy (61.1%), and blurred vision (50.0%). The rate of bilateral fistula was 11.1%, with all cases of bilateral fistula undergoing a second intervention. The primary intervention materials were Gold Balt balloon (77.8%) and coil (11.1%). The rate of patients requiring a second intervention was 27.8%, and the results of re-imaging after intervention showed complete occlusion in all cases (100.0%). After intervention, clinical symptoms were reduced or resolved in most cases (83.3-100.0%). The rate of early recurrence was low at 22.2%, with no cases of complications during intervention. Conclusion: Direct carotid-cavernous fistula is common in patients after trauma. The clinical presentation is relatively typical with common symptoms such as headache, conjunctival congestion, and proptosis. Endovascular intervention with Gold Balt balloon and coil achieves a high success rate and low complications. After intervention, most patients experience reduction or even complete resolution of symptoms.