Division of Neurosurgery, Department of Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.
Division of Neurosurgery, Department of Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
J Neurointerv Surg. 2022 Oct;14(10):1042-1044. doi: 10.1136/neurintsurg-2022-018751. Epub 2022 Apr 22.
A pediatric patient presented after a gunshot injury to the right shoulder and thorax region, with injuries requiring a thoracotomy, tracheal repair, axillary artery repair, and external fixation of the humerus. A CT scan of the brain showed a metal fragment in the interpeduncular cistern. CT angiography confirmed a pellet occluding the basilar apex. Successful endovascular retrieval resulted in mobilizing the pellet from the basilar apex to the left vertebral artery proximal to the posterior inferior cerebellar artery. This vertebral artery was then sacrificed proximally to prevent re-embolization. We present our technique and discuss endovascular options for management of intracranial arterial embolization of bullet fragments.
一名小儿患者因右肩部和胸部枪伤就诊，需要进行开胸手术、气管修复、腋动脉修复和肱骨外固定。脑部 CT 扫描显示中脑脚间池有金属碎片。CT 血管造影证实有一个弹丸阻塞基底动脉顶点。成功的血管内取出导致弹丸从基底动脉顶点移动到左侧椎动脉，靠近小脑后下动脉近端。然后在近端牺牲该椎动脉以防止再栓塞。我们介绍了我们的技术，并讨论了处理子弹碎片颅内动脉栓塞的血管内选择。
