Mascitelli Justin R, De Leacy Reade A, Oermann Eric K, Skovrlj Branko, Smouha Eric E, Ellozy Sharif H, Patel Aman B
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA.
BMJ Case Rep. 2014 Jun 30;2014:bcr2014011286. doi: 10.1136/bcr-2014-011286.
Cervical-petrous internal carotid artery (CP-ICA) pseudoaneurysms are rare and have different etiologies, presentations, and treatment options. A middle-aged patient with a history of chronic otitis media presented with acute otorrhagia and was found to have a left-sided CP-ICA pseudoaneurysm. The patient was a poor surgical candidate with difficult arterial access. The pseudoaneurysm was treated with stand-alone coiling via a left brachial approach with persistent contrast filling seen only in the aneurysm neck at the end of the procedure. The patient re-presented 12 days later with repeat hemorrhage and rapid enlargement of the neck remnant, and was treated with a covered stent via a transcervical common carotid artery cut-down. A covered stent may provide a more definitive treatment for CP-ICA pseudoaneurysms compared with standalone coiling.
颈-岩部颈内动脉（CP-ICA）假性动脉瘤较为罕见，其病因、临床表现及治疗方案各异。一名有慢性中耳炎病史的中年患者出现急性耳出血，经检查发现左侧CP-ICA假性动脉瘤。该患者手术条件较差，动脉入路困难。通过左肱动脉入路对假性动脉瘤进行单纯弹簧圈栓塞治疗，术后仅在瘤颈处见造影剂持续充盈。患者在12天后因再次出血及颈部残留部分迅速增大而复诊，遂通过经颈总动脉切开置入覆膜支架进行治疗。与单纯弹簧圈栓塞相比，覆膜支架可能为CP-ICA假性动脉瘤提供更确切的治疗。
