Lehmann Pierre, Saliou Guillaume, Page Cyril, Balut Antonia, Le Gars Daniel, Vallée Jean Noel
Department of Neuroradiology, Amiens University Hospital, 1 Place Victor Pauchet, 80054, Amiens Cedex 1, France.
Eur Arch Otorhinolaryngol. 2009 May;266(5):767-72. doi: 10.1007/s00405-008-0743-4. Epub 2008 Jun 24.
True carotid aneurysms with sphenoid extension and revealed by epistaxis are rare. A review of the literature shows the mortality risk of this pathology and the different therapeutic options. A 41-year-old female presented with a cavernous carotid aneurysm with sphenoid extension revealed by massive epistaxis. We propose a combined treatment of the affected vessel using coils and an uncovered stent. The first stage to stop the hemorrhages and occlude the aneurysm using the coil and the second stage several days later after anticoagulation using the stent to prevent revascularization. This treatment has been shown to be effective in producing immediate hemostasis and stable long-term occlusion.
伴有蝶窦扩展且由鼻出血发现的真性颈动脉动脉瘤很罕见。文献回顾显示了这种病变的死亡风险及不同的治疗选择。一名41岁女性因大量鼻出血发现患有伴有蝶窦扩展的海绵窦段颈动脉动脉瘤。我们建议对受累血管采用弹簧圈和裸支架联合治疗。第一阶段使用弹簧圈止血并闭塞动脉瘤,第二阶段在抗凝几天后使用支架以防止再血管化。已证明这种治疗在实现即刻止血和稳定的长期闭塞方面是有效的。