自发性颈内动脉夹层伴假性动脉瘤的急诊血管内治疗

Emergent endovascular treatment of a spontaneous internal carotid artery dissection with pseudoaneurysm.

作者信息

Tseng Albert, Ramaiah Venkatesh, Rodriguez-Lopez Julio A, Perkowshi Paul E, Del Santo Peter B, Gowda Ramesh G, Diethrich Edward B

机构信息

Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Hospital, Phoenix, Arizona 85006, USA.

出版信息

J Endovasc Ther. 2003 Jun;10(3):643-6. doi: 10.1177/152660280301000334.

DOI:10.1177/152660280301000334

PMID:12932180

Abstract

PURPOSE

To report the use of a coronary stent-graft for the endovascular treatment of a spontaneous internal carotid artery (ICA) dissection complicated by a large pseudoaneurysm.

CASE REPORT

A 68-year-old man presented to an outside hospital with complaints of headache, severe left-sided neck pain, fever, chills, and vomiting. Contrast-enhanced computed tomography revealed a large (3.5x3 cm) extracranial aneurysm of the left ICA. The patient was emergently transferred to our facility for endovascular treatment of the carotid aneurysm. Via a percutaneous access in the right common femoral artery, 2 Jostent coronary stent-grafts were deployed across the aneurysm with no evidence of a residual pseudoaneurysm. The patient was hemodynamically stable throughout the procedure. Duplex examination at 9 months revealed no evidence of a residual pseudoaneurysm, dissection, or endoleak.

CONCLUSIONS

Covered coronary stents may have a role in the treatment of spontaneous ICA dissection with pseudoaneurysm formation.

摘要

目的

报告使用冠状动脉覆膜支架对自发性颈内动脉（ICA）夹层并发大型假性动脉瘤进行血管内治疗的情况。

病例报告

一名68岁男性因头痛、左侧颈部剧痛、发热、寒战和呕吐就诊于外院。增强计算机断层扫描显示左侧颈内动脉有一个大型（3.5×3厘米）颅外动脉瘤。患者紧急转至我院接受颈动脉动脉瘤的血管内治疗。通过经皮穿刺右股总动脉，植入2枚Jostent冠状动脉覆膜支架覆盖动脉瘤，未发现残留假性动脉瘤。整个手术过程中患者血流动力学稳定。9个月时的双功超声检查未发现残留假性动脉瘤、夹层或内漏的迹象。