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血流导向装置治疗创伤性颈内动脉动脉瘤:单中心经验。

Treatment of Traumatic Internal Carotid Artery Aneurysm by Flow-Diverter: A Single-Center Experience.

机构信息

Department of Neurosurgery, Republic of Turkey Ministry of Health, Şehitkamil State Hospital, Clinic of Neurosurgery, Gaziantep, Turkey.

Department Neurosurgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.

出版信息

Neurochirurgie. 2022 Dec;68(6):e60-e67. doi: 10.1016/j.neuchi.2022.07.011. Epub 2022 Aug 23.

Abstract

AIM

Traumatic intracranial aneurysm (TICA) is a rare vascular lesion with various etiologies and a high mortality rate when diagnosed late. In this study, we present our cases of TICA, which we treated with flow-diverter stents due to different etiological factors.

METHODS

Clinical data were recorded for 8 patients: age, gender, etiological factors, aneurysm location, aneurysm type, rupture, main artery status, and postoperative complications.

RESULTS

75% (n:6) of the patients were male and 25% (n:2) female. Etiologically, there was intracranial tumor surgery in 3 cases (37.5%), fall from height in 2 (25%), road accident in 2 (25%), and blunt trauma in 1 (12.5%). Reconstruction used a flow-diverting stent in all cases. One patient experienced intraoperative iatrogenic rupture of the distal arterioles due to a microwire. Mean angiographic follow-up was 17.8 months (range, 6-32 months). During follow-up, none of the patients required renewed endovascular treatment.

CONCLUSION

Traumatic aneurysm is a vascular lesion with high mortality when diagnosed late. In case of suspected vascular injury after trauma or intracranial surgery, further evaluation should be performed without delay. TICA can be safely treated with flow-diverter stents, conserving the main artery.

摘要

目的

创伤性颅内动脉瘤(TICA)是一种罕见的血管病变,病因多样,诊断延迟时死亡率很高。本研究报告了我们采用血流导向装置治疗因不同病因导致 TICA 的病例。

方法

记录了 8 例患者的临床资料:年龄、性别、病因、动脉瘤位置、动脉瘤类型、破裂、主要动脉状态和术后并发症。

结果

75%(n=6)的患者为男性,25%(n=2)为女性。病因方面,颅内肿瘤手术 3 例(37.5%),高处坠落 2 例(25%),交通事故 2 例(25%),钝性创伤 1 例(12.5%)。所有病例均采用血流导向装置重建。1 例患者因微导丝导致远端小动脉医源性破裂。平均血管造影随访时间为 17.8 个月(6-32 个月)。随访期间,无一例患者需要再次进行血管内治疗。

结论

创伤性动脉瘤是一种血管病变,如果诊断延迟,死亡率很高。对于创伤或颅内手术后怀疑血管损伤的情况,应及时进行进一步评估。对于创伤性颅内动脉瘤,采用血流导向装置治疗可以安全地保留主要动脉。

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