Hattori Yasuhiko, Sugiu Kenji, Hishikawa Tomohito, Tokunaga Koji, Takahashi Kazuya, Date Isao
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-city, Okayama, Japan.
No Shinkei Geka. 2013 Jun;41(6):515-23.
We report here a case of cervical carotid artery aneurysm. This 37-year-old male suffered from acute neck swelling when he was taking lunch after physical work. Ultrasonography demonstrated a cervical pseudoaneurysm and a jet flow, which was blowing into the dome from the carotid artery. Angiogram revealed an aneurysm with a diameter of 3 cm at the bifurcation of the common carotid artery. Coil embolization using double-catheter technique was performed and complete occlusion of the aneurysm was obtained without any complications. The patient returned to his normal life. Cervical carotid artery aneurysms are rare and they induce pain by swelling in the neck, hoarseness, swallowing disturbance, hemorrhage, and cerebral ischemia due to embolism. In case of a cervical carotid artery aneurysm, safe and effective treatments are required and endovascular treatment should be considered. Although stent-assisted coil embolization or covered-stent placement were reported as an effective treatment for cervical aneurysms, coil embolization without using a stent was performed in this particular patient who is a young, blue-collar worker because the avoidance of long-term anti-platelet therapy was desirable. Preoperative evaluation is important to select adequate treatment.
我们在此报告一例颈总动脉动脉瘤病例。该37岁男性在体力劳动后吃午饭时突发颈部肿胀。超声检查显示为颈部假性动脉瘤及喷射血流，血流从颈动脉向瘤顶喷射。血管造影显示颈总动脉分叉处有一个直径3厘米的动脉瘤。采用双导管技术进行了弹簧圈栓塞，动脉瘤完全闭塞，未出现任何并发症。患者恢复了正常生活。颈总动脉动脉瘤较为罕见，可因颈部肿胀、声音嘶哑、吞咽障碍、出血及栓塞导致脑缺血而引起疼痛。对于颈总动脉动脉瘤，需要安全有效的治疗方法，应考虑血管内治疗。尽管有报道称支架辅助弹簧圈栓塞或覆膜支架置入术是治疗颈部动脉瘤的有效方法，但对于这位年轻的蓝领工人患者，由于希望避免长期抗血小板治疗，因此未使用支架进行了弹簧圈栓塞。术前评估对于选择合适的治疗方法很重要。
