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创伤后颈总动脉假性动脉瘤的血管内治疗

Endovascular treatment of posttraumatic pseudoaneurysm of the common carotid artery.

作者信息

Rojas Diego, Stefanov Stefan, Riera Del Moral Luis, Álvarez Jesús, Riera de Cubas Luis

机构信息

Department of Vascular Surgery, La Paz University Hospital, 28046 Madrid, Spain.

出版信息

Case Rep Vasc Med. 2015;2015:427040. doi: 10.1155/2015/427040. Epub 2015 Mar 31.

Abstract

Carotid artery injuries with pseudoaneurysm are uncommon but associated with central neurologic dysfunction. We present a case of posttraumatic pseudoaneurysm of the right common carotid artery treated by implantation of a covered stent. A 44-year-old woman with multiple injuries after fall from height presents a small dissection flap of the right common carotid artery (RCCA) on the initial computed tomography angiography (CTA). Fifteen days later a 10 mm pseudoaneurysm is observed on control CTA. We decided endovascular treatment. Through right femoral access with a long introducer sheath placed in the innominate artery, we implanted a covered stent Advanta V12 9 × 38 mm in the RCCA. The patient was discharged from the hospital with antiplatelet therapy without any neurological dysfunction and complete exclusion of the pseudoaneurysm. Use of covered stents has emerged as a safe and effective alternative to surgical repair of carotid injuries.

摘要

伴有假性动脉瘤的颈动脉损伤并不常见,但与中枢神经功能障碍有关。我们报告一例通过植入覆膜支架治疗的创伤后右侧颈总动脉假性动脉瘤病例。一名44岁女性从高处坠落致多处损伤,初次计算机断层血管造影(CTA)显示右侧颈总动脉(RCCA)有一小片内膜撕裂瓣。15天后复查CTA发现一个10毫米的假性动脉瘤。我们决定进行血管内治疗。通过右股动脉入路,将一个长的导入鞘置于无名动脉,我们在RCCA植入了一个9×38毫米的Advanta V12覆膜支架。患者接受抗血小板治疗后出院,无任何神经功能障碍,假性动脉瘤完全隔绝。使用覆膜支架已成为颈动脉损伤手术修复的一种安全有效的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b652/4396546/79cf7f92c4e2/CRIVAM2015-427040.002.jpg

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