Kumar Subhash, Sharma Rohitash, Goyal Sumit, Husain Shakir
Department of Interventional Neurology, Max Superspeciality Hospital, Saket, New Delhi, India.
J Neurosci Rural Pract. 2011 Jul;2(2):178-9. doi: 10.4103/0976-3147.83588.
The transmastoid branch of the occipital artery is an important supply to posterior fossa vascular malformations and tumors and is often difficult to catheterize due to tortuosity and a transforaminal course. In very difficult situations, we can try to induce spasm of the occipital artery just beyond the origin of the mastoid branch by repeated passages of the microcatheter/wire. This induces a temporary 'ligation' like effect so that the microcatheter can then be manipulated into the mastoid branch via the mastoid foramen. Rarely, the occipital artery has to be sacrificed if spasm cannot be induced or is short living, following which particles can be injected from a distance without entering the mastoid foramen. Occluding the occipital artery proximally has no effect on distal perfusion, as collaterals and anastomoses from superficial temporal artery, posterior auricular artery, and opposite occipital artery take over the supply.
枕动脉的乳突支是后颅窝血管畸形和肿瘤的重要供血来源，由于其走行迂曲且经孔道，常常难以进行导管插入。在非常困难的情况下，我们可以通过反复推送微导管/导丝，尝试在乳突支起始部之外诱发枕动脉痉挛。这会产生一种类似临时“结扎”的效果，以便随后可将微导管经乳突孔操纵进入乳突支。极少情况下，如果无法诱发痉挛或痉挛持续时间短，则必须牺牲枕动脉，之后可从远处注射颗粒而不进入乳突孔。近端闭塞枕动脉对远端灌注没有影响，因为颞浅动脉、耳后动脉和对侧枕动脉的侧支循环和吻合支会接管供血。
