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颞浅动脉创伤性假性动脉瘤的治疗方案

Treatment protocol of traumatic pseudoaneurysm of the superficial temporal artery.

作者信息

Kim Sang Wha, Jong Kim Eui, Sung Kun-Yong, Kim Jeong Tae, Kim Youn Hwan

机构信息

Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea.

出版信息

J Craniofac Surg. 2013 Jan;24(1):295-8. doi: 10.1097/SCS.0b013e31827136f6.

Abstract

Pseudoaneurysm of the superficial temporal artery is an unusual complication. Diagnosis is based on clinical findings and radiologic study. The standard treatment is surgical ligation and resection, and other treatment options include radiologic intervention, thrombin injection, and conservative treatment. In this article, the authors report several cases of pseudoaneurysm and suggest a treatment protocol to manage pseudoaneurysm of the superficial temporal artery.We conducted a retrospective review of 11 patients who underwent treatment of superficial temporal artery pseudoaneurysm between April 2002 and July 2011. According to the duration of the aneurysm, we divided the superficial temporal artery pseudoaneurysms into 3 stages: "Acute" stage is less than 3 weeks, "Subacute" stage is from 3 weeks to 3 months, and "Chronic" stage is more than 3 months.Among the 11 patients who were diagnosed with superficial temporal artery pseudoaneurysms, 7 cases were treated by surgical resection, 2 cases by conservative treatment, 2 cases by thrombin injection, and 1 case by radiologic intervention. There was no recurrence during the follow-up periods.The most successful standard treatment is surgical resection. More recently, many nonsurgical treatments have been used, such as conservative treatment, thrombin injection, endovascular embolization, or coiling. Every method has its advantages and disadvantages and should be chosen according to the chronicity and size of the pseudoaneurysm, patient's clinical status, including hemodynamic stability, patient's aesthetic preferences, and compliance. The authors suggest a systematic treatment protocol depending on the stage of the pseudoaneurysm, patients' status, and preferences.

摘要

颞浅动脉假性动脉瘤是一种罕见的并发症。诊断基于临床发现和影像学检查。标准治疗方法是手术结扎和切除,其他治疗选择包括放射介入、凝血酶注射和保守治疗。在本文中,作者报告了几例假性动脉瘤病例,并提出了一种治疗颞浅动脉假性动脉瘤的方案。我们对2002年4月至2011年7月间接受颞浅动脉假性动脉瘤治疗的11例患者进行了回顾性研究。根据动脉瘤的病程,我们将颞浅动脉假性动脉瘤分为3个阶段:“急性”阶段小于3周,“亚急性”阶段为3周~3个月,“慢性”阶段超过3个月。在11例被诊断为颞浅动脉假性动脉瘤的患者中,7例接受了手术切除治疗,2例接受了保守治疗,2例接受了凝血酶注射治疗,1例接受了放射介入治疗。随访期间均无复发。最成功的标准治疗方法是手术切除。最近,许多非手术治疗方法也被采用,如保守治疗、凝血酶注射、血管内栓塞或弹簧圈栓塞。每种方法都有其优缺点,应根据假性动脉瘤的病程和大小、患者的临床状况(包括血流动力学稳定性)、患者的美学偏好和依从性来选择。作者根据假性动脉瘤的阶段、患者状况和偏好提出了一种系统的治疗方案。

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