Maras Dimitrios, Lioupis Christos, Magoufis George, Tsamopoulos Nikolaos, Moulakakis Konstantinos, Andrikopoulos Vasilios
Department of Vascular Surgery, The Red Cross Hospital of Athens, Athens, Greece.
Cardiovasc Intervent Radiol. 2006 Nov-Dec;29(6):958-68. doi: 10.1007/s00270-005-0367-7.
To review the literature concerning the management with placement of covered stent-grafts of traumatic pseudoaneurysms of the extracranial internal carotid artery (ICA) resulting from penetrating craniocervical injuries or skull base fractures.
We have reviewed, from the Medline database, all the published cases in the English literature since 1990 and we have added a new case.
We identified 20 patients with traumatic extracranial ICA pseudoaneurysms due to penetrating craniocervical injuries or skull base fractures who had been treated with covered stent-graft implantation. Many discrepancies have been ascertained regarding the anticoagulation therapy. In 3 patients the ICA was totally occluded in the follow-up period, giving an overall occlusion rate 15%. No serious complication was reported as a result of the endovascular procedure.
Preliminary results suggest that placement of stent-grafts is a safe and effective method of treating ICA traumatic pseudoaneurysms resulting from penetrating craniocervical injuries or skull base fractures. The immediate results are satisfactory when the procedure takes place with appropriate anticoagulation therapy. The periprocedural morbidity and mortality and the early patency are also acceptable. A surveillance program with appropriate interventions to manage restenosis may improve the long-term patency.
回顾有关采用覆膜支架植入术治疗因颅颈穿透伤或颅底骨折导致的颅外颈内动脉（ICA）创伤性假性动脉瘤的文献。
我们检索了Medline数据库中自1990年以来英文文献报道的所有病例，并增加了1例新病例。
我们确定了20例因颅颈穿透伤或颅底骨折导致颅外ICA创伤性假性动脉瘤并接受覆膜支架植入术治疗的患者。在抗凝治疗方面发现了许多差异。3例患者在随访期间ICA完全闭塞，总体闭塞率为15%。未报告血管内手术导致的严重并发症。
初步结果表明，支架植入术是治疗因颅颈穿透伤或颅底骨折导致的ICA创伤性假性动脉瘤的一种安全有效的方法。在适当的抗凝治疗下进行该手术时，即刻效果令人满意。围手术期发病率和死亡率以及早期通畅率也是可以接受的。通过适当干预管理再狭窄的监测计划可能会提高长期通畅率。
