de Souza Jorge Marcondes, Domingues Flavio S, Espinosa Gaudencio, Gadelha Monica
Service of Neurosurgery, Department of Surgery, Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Arq Neuropsiquiatr. 2003 Jun;61(2B):459-62. doi: 10.1590/s0004-282x2003000300025. Epub 2003 Jul 28.
We report on a case of endovascular management of pseudoaneurysm of the cavernous segment of the internal carotid artery with covered stent reconstruction. A 36 years-old woman with a history of previous transsphenoidal approach for pituitary macroadenoma and false aneurysma formation was studied in a protocol that included balloon test occlusion and cerebral blood flow evaluation. An endovascular covered stent deployment in the area of the carotid laceration was performed with isolation of the aneurysm from the circulation and maintenance of the carotid flow. Helical angio-CT and cerebral digital subtraction angiography showed the carotid preservation without stenosis in the stented area. In conclusion, endovascular stent reconstruction for post-transsphenoidal carotid artery laceration and false aneurysm is demonstrated as useful technical adjunct in the management strategy and with the potential for carotid sacrifice morbidity avoidance.
我们报告了一例采用覆膜支架重建术对颈内动脉海绵窦段假性动脉瘤进行血管内治疗的病例。一名36岁女性，既往有垂体大腺瘤经蝶窦入路手术史及假性动脉瘤形成，纳入了包括球囊试验闭塞和脑血流评估的方案进行研究。在颈动脉裂伤区域进行血管内覆膜支架置入，使动脉瘤与循环隔离并维持颈动脉血流。螺旋血管造影CT和脑数字减影血管造影显示支架置入区域颈动脉保持通畅无狭窄。总之，经蝶窦手术后颈动脉裂伤和假性动脉瘤的血管内支架重建术被证明是管理策略中的一项有用技术辅助手段，具有避免颈动脉牺牲相关并发症的潜力。
