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.
J Neurointerv Surg. 2015 Jul;7(7):e25. doi: 10.1136/neurintsurg-2014-011286.rep. Epub 2014 Jul 4.
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，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。该患者手术条件差，动脉入路困难。通过左肱动脉入路单独进行弹簧圈栓塞治疗假性动脉瘤，术后造影显示仅动脉瘤颈部有持续性造影剂充盈。患者在12天后再次出现出血，颈部残留病变迅速增大，遂通过经颈总动脉切开置入覆膜支架进行治疗。与单独弹簧圈栓塞相比，覆膜支架可能为CP-ICA假性动脉瘤提供更确切的治疗。
