在颈动脉内膜切除术中使用纤维蛋白和明胶固定修复扭结的颈内动脉。
The use of fibrin and gelatin fixation to repair a kinked internal carotid artery in carotid endarterectomy.
作者信息
Kubota Hisashi, Sanada Yasuhiro, Tanikawa Rokuya, Kato Amami
机构信息
Department of Neurosurgery, Kindai University Faculty of Medicine, Osaka, Japan.
Department of Neurosurgery, Stroke Center, Teishinkai Hospital, Hokkaido, Japan.
出版信息
Surg Neurol Int. 2016 Jun 3;7(Suppl 15):S434-6. doi: 10.4103/2152-7806.183542. eCollection 2016.
BACKGROUND
The kinking of the internal carotid artery (ICA) after final closure in carotid endarterectomy (CEA) is thought to be uncommon. When it occurs, it is mandatory to reconstruct ICA to preserve normal blood flow. We herein present a case in which a fixation technique was applied to repair an ICA that became kinked during CEA.
CASE DESCRIPTION
A 68-year-old man presented with cerebral infarction due to an artery-to-artery embolism from the right cervical ICA stenosis. CEA was performed 12 days after admission. After final closure, a distal portion of ICA was found to have been kinked following plaque resection in CEA procedure. Fixation with fibrin glue and gelatin was used to reinforce the arterial wall and repair the kink. Postoperative magnetic resonance angiography demonstrated the release of the kink in ICA.
CONCLUSION
Fixation with fibrin and gelatin is a salvage armamentarium that can be considered in CEA for the repair of kinked or tortuous ICA.
背景
颈动脉内膜切除术（CEA）最终闭合后颈内动脉（ICA）扭结被认为并不常见。当这种情况发生时，必须重建ICA以维持正常血流。我们在此报告一例在CEA期间应用固定技术修复扭结的ICA的病例。
病例描述
一名68岁男性因右侧颈段ICA狭窄导致动脉到动脉栓塞而出现脑梗死。入院12天后进行了CEA。最终闭合后，发现在CEA手术中切除斑块后ICA远端部分发生了扭结。使用纤维蛋白胶和明胶进行固定以加固动脉壁并修复扭结。术后磁共振血管造影显示ICA扭结解除。
结论
纤维蛋白和明胶固定是一种挽救手段，在CEA中可考虑用于修复扭结或迂曲的ICA。
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