Zhao Yueyuan, Liu Zhiwen, Sun Ronghui, Pan Li, Yang Ming, Song Jian, Ma Lianting
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Neurosurgery, General Hospital of Central Theater Command, Wuhan, China.
Front Neurol. 2021 Oct 6;12:739222. doi: 10.3389/fneur.2021.739222. eCollection 2021.
To investigate the safety and efficacy of Willis covered stents (WCS) in the treatment of traumatic pseudoaneurysm of the cranial internal carotid artery (CICA). Fifteen patients with traumatic pseudoaneurysm of the intracranial segment of the ICA treated with the WCS system at our institution from 2013 to 2019 were analyzed retrospectively. Follow-up observation and digital subtraction angiography (DSA) examination were conducted ~6 months after the treatment. DSA performed immediately after stent deployment revealed that complete occlusion of the lesion was achieved in 13 patients and that endoleak occurred in two patients. In 12 patients, postoperative DSA examination indicated that the lesions were completely occluded. In two patients who had a second stent implantation at the break of the ICA, traumatic ICA rupture was essentially completely obstructed in 1 patient. The endoleak remained in one patient with carotid cavernous sinus fistula because the placement of the second stent system was difficult with his ICA tortuosity. No recurrence of aneurysms, hemorrhage, or other lesions was observed, and the patients' parent arteries were patent without stenosis. No procedure-related complications or ischemic strokes occurred during the follow-up period of ~6 months. For treatment of traumatic pseudoaneurysm of the CICA, Willis covered stent implantation in some appropriate cases, is safe and effective. However, large-sample controlled studies and multicenter studies are needed for further confirmation.
探讨Willis覆膜支架(WCS)治疗颈内动脉颅内段(CICA)创伤性假性动脉瘤的安全性和有效性。回顾性分析2013年至2019年在我院接受WCS系统治疗的15例ICA颅内段创伤性假性动脉瘤患者。治疗后约6个月进行随访观察和数字减影血管造影(DSA)检查。支架置入后立即进行的DSA显示,13例患者病变完全闭塞,2例患者发生内漏。12例患者术后DSA检查显示病变完全闭塞。2例在ICA破裂处进行二次支架植入的患者中,1例创伤性ICA破裂基本完全阻塞。1例合并颈内动脉海绵窦瘘的患者内漏持续存在,因为其ICA迂曲,二次支架系统置入困难。未观察到动脉瘤复发、出血或其他病变,患者的供血动脉通畅无狭窄。在约6个月的随访期内未发生与手术相关的并发症或缺血性卒中。对于CICA创伤性假性动脉瘤的治疗,在某些合适的病例中,Willis覆膜支架植入是安全有效的。然而,需要大样本对照研究和多中心研究进一步证实。