Weber W, Nahser H C, Henkes H, Berg-Dammer E, Kühne D
Klinik für Allgemeine Röntgendiagnostik und Neuroradiologie, Alfried Krupp Krankenhaus, Essen.
Nervenarzt. 1999 Oct;70(10):870-7. doi: 10.1007/s001150050590.
Pseudoaneurysms of the extracranial internal carotid artery (ICA) can be caused by external injury or may be due to spontaneous dissection. Pseudoaneurysms bear an increased risk of arterio-arterial embolism. Treatment of pseudoaneurysms is influenced by the location and the type of injury, associated injuries, collaterals to the ipsilateral hemisphere, neurological signs and symptoms, growth of the lesion and patient age. Potential treatment regimen include conservative and medical approaches with anticoagulation and antiplatelet therapy, extra-intracranial bypass, resection of the pseudoaneurysm with vessel reconstruction, ligation or endovascular balloon occlusion of the ICA. Pseudoaneurysms of the ICA adjacent to the skull base require a major surgical procedure. If there are contra-indications for vessel occlusion conservative or medical treatment used to be the only therapeutic alternatives. We report the treatment of two patients with extracranial ICA pseudoaneurysms after blunt injury with stent placement (in one case combined with coil embolization) as a further treatment option.
颅外颈内动脉(ICA)假性动脉瘤可由外部损伤引起,也可能是自发性夹层所致。假性动脉瘤发生动脉-动脉栓塞的风险增加。假性动脉瘤的治疗受损伤部位、类型、相关损伤、同侧半球的侧支循环、神经体征和症状、病变生长情况以及患者年龄的影响。潜在的治疗方案包括抗凝和抗血小板治疗的保守及药物方法、颅外-颅内搭桥术、假性动脉瘤切除并血管重建、ICA结扎或血管内球囊闭塞。颅底附近的ICA假性动脉瘤需要进行大型外科手术。如果存在血管闭塞的禁忌证,保守或药物治疗曾是唯一的治疗选择。我们报告了两例钝性损伤后颅外ICA假性动脉瘤患者采用支架置入术(1例联合弹簧圈栓塞)作为进一步治疗选择的治疗情况。