Lee Stephen R, Metwalli Zeyad A, Yevich Steven M, Whigham Cliff J, Benndorf Goetz
Department of Radiology, Baylor College of Medicine; Houston, TX, USA -
Interv Neuroradiol. 2013 Dec;19(4):489-95. doi: 10.1177/159101991301900414. Epub 2013 Dec 18.
This study reports the differences in evolution and course of multiple pseudoaneurysms (PAs) and an axillary arteriovenous fistula (AVF) after penetrating vascular trauma due to shotgun injury to the head and neck. We describe the unusual case of a young man who, following penetrating shotgun injuries to the head and neck, developed multiple PAs of the common carotid, vertebral and superficial temporal arteries as well as an axillary AVF. Serial angiographic follow-up studies documented differences in time of occurrence, evolution and course of these lesions. This allowed for tailored management using endovascular (AVF, superficial temporal artery PAs) and conservative (carotid and vertebral PAs) treatment. No complication occurred and complete cure of all lesions was achieved and documented after seven months. Time of occurrence, evolution and regression of penetrating vascular injuries can differ significantly even in the same patient. Close angiographic follow-up helps not only detect a lesion with delayed occurrence, but also provides a practical basis for decision-making for optimal therapeutic management.
本研究报告了因头颈部猎枪伤导致穿透性血管创伤后多发性假性动脉瘤（PA）和腋动静脉瘘（AVF）的演变及病程差异。我们描述了一名年轻男性的罕见病例，该患者头颈部遭受穿透性猎枪伤后，出现了颈总动脉、椎动脉和颞浅动脉的多发性PA以及腋部AVF。系列血管造影随访研究记录了这些病变的发生时间、演变过程和病程差异。这使得可以采用血管内治疗（AVF、颞浅动脉PA）和保守治疗（颈动脉和椎动脉PA）进行针对性管理。未发生并发症，七个月后所有病变均实现完全治愈并得到记录。即使在同一患者中，穿透性血管损伤的发生时间、演变过程和消退情况也可能有显著差异。密切的血管造影随访不仅有助于检测延迟出现的病变，还为最佳治疗管理的决策提供了实际依据。
