经蝶窦手术中颈内动脉破裂的治疗。两例采用两种不同的血管内治疗策略。
Treatment of ruptured ICA during transsphenoidal surgery. Two different endovascular strategies in two cases.
作者信息
Ghatge S B, Modi D B
机构信息
Department of Interventional Neuroradiology, Bombay Hospital; Mumbai, India.
出版信息
Interv Neuroradiol. 2010 Mar;16(1):31-7. doi: 10.1177/159101991001600104. Epub 2010 Mar 25.
Abstract
Rupture of the internal carotid artery (ICA) during transsphenoidal surgery is a rare but potentially lethal complication. Direct surgical repair of the ICA may be difficult and time-consuming in an acute setting. Urgent endovascular treatments with vascular plug or stent-graft have been the feasible options to date. We desrcibe two cases of iatrogenic rupture of ICA during transsphenoidal surgery. In the first case we occluded the ICA with a vascular plug at the site of tear where cross circulation was adequate. In the second case we had to preserve the ICA with stent-graft since there was no adequate cross circulation. These two strategies are discussed below.
摘要
经蝶窦手术期间颈内动脉（ICA）破裂是一种罕见但可能致命的并发症。在急性情况下，直接对ICA进行手术修复可能困难且耗时。迄今为止，使用血管栓塞物或覆膜支架进行紧急血管内治疗一直是可行的选择。我们描述了两例经蝶窦手术期间ICA医源性破裂的病例。在第一例中，我们在撕裂部位用血管栓塞物闭塞了ICA，此处侧支循环充足。在第二例中，由于没有足够的侧支循环，我们不得不使用覆膜支架保留ICA。以下将讨论这两种策略。
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