Qiu Min-Jian, Zhang Bao-Rong, Song Shui-Jiang
Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
World J Clin Cases. 2022 Feb 16;10(5):1602-1608. doi: 10.12998/wjcc.v10.i5.1602.
There is no standard endovascular treatment for extracranial internal carotid artery dissecting aneurysms. In the past, stent-graft isolation and stent-assisted coil embolization were commonly used for wide-necked and fusiform aneurysms. Here, we present two cases of extracranial internal carotid artery dissecting aneurysms treated successfully using the SUPERA stent.
Case 1 was a 57-year-old male patient with sudden right limb weakness and vague speech and diagnosed with cerebral infarction in February 2019. Cervical computed tomographic angiography (CTA) revealed left internal carotid artery dissection with stenosis. CTA at 2 mo showed an eccentric wide-necked dissecting aneurysm (5 mm × 5 mm × 12 mm, 10-mm neck) that was enlarged at 4 mo (7 mm × 6 mm × 12 mm, 11-mm neck). The patient underwent SUPERA stent implantation. His condition was stable in July 2020. Case 2 was a 57-year-old man who suddenly felt dizzy and developed unsteady walking in November 2019. Cervical CTA suggested right internal carotid artery dissecting aneurysm (11 mm × 9 mm × 31 mm) complicated with severe lumen stenosis (95%). The patient underwent SUPERA stent implantation. The patient had no residual symptoms and was stable in December 2020.
SUPERA stent implantation might achieve good results in treating wide-necked or long fusiform internal carotid artery dissecting aneurysms.
颅外颈内动脉夹层动脉瘤尚无标准的血管内治疗方法。过去，支架移植物隔离术和支架辅助弹簧圈栓塞术常用于治疗宽颈和梭形动脉瘤。在此，我们报告两例使用SUPERA支架成功治疗的颅外颈内动脉夹层动脉瘤病例。
病例1为一名57岁男性患者，突发右肢无力、言语含糊，于2019年2月被诊断为脑梗死。颈部计算机断层血管造影（CTA）显示左颈内动脉夹层伴狭窄。2个月时的CTA显示一个偏心宽颈夹层动脉瘤（5毫米×5毫米×12毫米，颈宽10毫米），4个月时增大（7毫米×6毫米×12毫米，颈宽11毫米）。该患者接受了SUPERA支架植入术。其病情在2020年7月稳定。病例2为一名57岁男性，2019年11月突然感到头晕，行走不稳。颈部CTA提示右颈内动脉夹层动脉瘤（11毫米×9毫米×31毫米）合并严重管腔狭窄（95%）。该患者接受了SUPERA支架植入术。患者无残留症状，于2020年12月病情稳定。
SUPERA支架植入术在治疗宽颈或长梭形颈内动脉夹层动脉瘤方面可能取得良好效果。
