Martinelli Ombretta, Fresilli Mauro, Jabbour Jihad, Di Girolamo Alessia, Irace Luigi
Vascular Surgery Division, "Paride Stefanini" Department, Policlinico "Umberto I", Sapienza University of Rome, Rome, Italy.
Vascular Surgery Division, "Paride Stefanini" Department, Policlinico "Umberto I", Sapienza University of Rome, Rome, Italy.
Ann Vasc Surg. 2019 Jul;58:379.e1-379.e3. doi: 10.1016/j.avsg.2018.09.043. Epub 2019 Jan 24.
Atherosclerotic plaques concomitantly with the hyoid bone protrusion into the internal carotid artery (ICA) are rarely reported in the literature. These plaques can be considered as arising from the turbulent flow and the shear stress caused by the close contact between the hyoid bone and the arterial wall carotid artery. The carotid stenosis was greater than 70%. We report a patient with a transient ischemic attack and a right significant carotid artery stenosis presumably due to a compression of an elongated ICA by the hyoid bone. The patient was submitted to open surgery to remove the plaque and correct the anomalous course of ICA combined with the lysis of the arterial adhesions with the right greater horn of the hyoid bone. The hyoid bone is a remote cause of injury and subsequent atherosclerotic lesions of carotid vessels. Elongation of the carotid artery can alter its course and can favor the mechanical interference with the hyoid bone and the subsequent arterial wall damage. When an external compression of the carotid artery is viewed, the endovascular treatment of the carotid artery stenosis is not advisable and open surgery is mandatory.
文献中很少报道动脉粥样硬化斑块伴随舌骨突入颈内动脉（ICA）的情况。这些斑块可被认为是由舌骨与颈动脉壁紧密接触所引起的湍流和剪切应力导致的。颈动脉狭窄超过70%。我们报告一例患者，其患有短暂性脑缺血发作和右侧严重颈动脉狭窄，推测是由于舌骨对伸长的颈内动脉的压迫所致。该患者接受了开放手术，以切除斑块并纠正颈内动脉的异常走行，同时松解颈内动脉与舌骨右大角的动脉粘连。舌骨是颈动脉损伤及随后动脉粥样硬化病变的一个间接原因。颈动脉伸长可改变其走行，并可能加剧对舌骨的机械干扰以及随后的动脉壁损伤。当考虑到颈动脉受到外部压迫时，颈动脉狭窄的血管内治疗并不适宜，开放手术是必要的。
