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鼻咽癌患者放射性诱导的颈内动脉假性动脉瘤破裂——因长期栓塞作用导致颈动脉自发闭塞

Rupture of radiation-induced internal carotid artery pseudoaneurysm in a patient with nasopharyngeal carcinoma--spontaneous occlusion of carotid artery due to long-term embolizing performance.

作者信息

Cheng Kai-Yuan, Lee Ka-Wo, Chiang Feng-Yu, Ho Kuen-Yao, Kuo Wen-Rei

机构信息

Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Head Neck. 2008 Aug;30(8):1132-5. doi: 10.1002/hed.20753.

Abstract

BACKGROUND

Rupture of internal carotid artery (ICA) pseudoaneurysm is a lethal complication in patients with nasopharyngeal carcinoma (NPC). Angiography is the best diagnostic and treatment method. The aim of embolization is to block the pseudoaneurysm; but sometimes, total occlusion of great vessels is ineludible. We describe a case of NPC post-radiation therapy and with ruptured pseudoaneurysm treated by angio-embolization.

METHODS

The patient had received embolization with numerous tools such as stent grafts, balloons, and bare stents with or without filter protection.

RESULTS

After failing to pass through the narrow lumen by embolizing tools, the right ICA finally occluded spontaneously by self-thrombosis.

CONCLUSION

Although the angio-embolization is a good method to resolve the problems of ruptured pseudoaneurysm, there is still high mortality and morbidity. Being aware of the clinical presentations and the changes of images may alert us to predict the happening earlier.

摘要

背景

颈内动脉(ICA)假性动脉瘤破裂是鼻咽癌(NPC)患者的致命并发症。血管造影是最佳的诊断和治疗方法。栓塞的目的是封堵假性动脉瘤;但有时大血管的完全闭塞不可避免。我们描述了一例接受放射治疗后并发假性动脉瘤破裂的鼻咽癌患者,采用血管栓塞治疗。

方法

该患者接受了多种工具的栓塞治疗,如带膜支架、球囊以及有无滤器保护的裸支架。

结果

栓塞工具未能通过狭窄管腔后,右侧颈内动脉最终因自血栓形成而自发闭塞。

结论

尽管血管栓塞是解决假性动脉瘤破裂问题的良好方法,但仍有较高的死亡率和发病率。了解临床表现和影像学变化可能有助于我们更早地预测其发生。

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