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伴有颈内动脉瘤的180度颈动脉分叉

180-degre carotid bifurcation with an internal carotid artery aneurysm.

作者信息

Keshelava Grigol, Kovziridze David, Robakidze Zurab

机构信息

Department of Vascular Surgery, Clinic "Helsicore", Tevdore Mgvdeli St. 13, 0121, Tbilisi, Georgia.

Department of Vascular Surgery, West Georgian National Centre of Interventional Medicine, Kutaisi, Georgia.

出版信息

Surg Radiol Anat. 2023 Jun;45(6):769-771. doi: 10.1007/s00276-023-03136-5. Epub 2023 Mar 29.

DOI:10.1007/s00276-023-03136-5
PMID:36988676
Abstract

PURPOSE

Internal carotid artery (ICA) aneurysm is a rare pathology. In the clinical case we present, the patient had an ICA aneurysm as well as a rare anatomical variant of the carotid bifurcation.

METHODS

We present the case of a 45 year old man, who had two episodes of TIA revealed by loss of mind. Computed tomography revealed the fusiform aneurysm of a left ICA in the first segment with maximal diameter of 16 mm. There were no thrombotic mass in the dilated area. The carotid bifurcation angle was 180 degree. Although the aneurysm did not contain a thrombus mass, it was considered the source of the TIA because of turbulent blood flow.

RESULTS

Distal and proximal ligation was performed. A 5-cm long graft from the great saphenous vein was used for ICA revascularization from common carotid artery.

CONCLUSION

In our case, geometry of carotid bifurcation may have contributed to the ICA aneurysm, although there is no evidence for this correlation.

摘要

目的

颈内动脉(ICA)动脉瘤是一种罕见的病变。在我们呈现的临床病例中,患者既有颈内动脉动脉瘤,又有罕见的颈动脉分叉解剖变异。

方法

我们介绍了一名45岁男性的病例,他因意识丧失发作了两次短暂性脑缺血发作(TIA)。计算机断层扫描显示左侧颈内动脉第一段有梭形动脉瘤,最大直径为16毫米。扩张区域没有血栓形成。颈动脉分叉角度为180度。尽管动脉瘤内没有血栓,但由于血流紊乱,它被认为是短暂性脑缺血发作的来源。

结果

进行了远端和近端结扎。使用一段5厘米长的大隐静脉移植物从颈总动脉进行颈内动脉血运重建。

结论

在我们的病例中,颈动脉分叉的几何结构可能促成了颈内动脉动脉瘤,尽管尚无证据支持这种相关性。

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Sci Rep. 2022 Mar 23;12(1):4932. doi: 10.1038/s41598-022-09062-7.
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Longitudinal study of carotid artery bifurcation geometry using magnetic resonance angiography.利用磁共振血管造影术对颈动脉分叉处几何结构的纵向研究。
Vascular. 2019 Jun;27(3):312-317. doi: 10.1177/1708538119828262. Epub 2019 Feb 7.
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Evaluation of the impact of carotid artery bifurcation angle on hemodynamics by use of computational fluid dynamics: a simulation and volunteer study.
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Radiol Phys Technol. 2016 Jul;9(2):277-85. doi: 10.1007/s12194-016-0360-7. Epub 2016 Jun 2.
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Variation in the carotid bifurcation geometry of young versus older adults: implications for geometric risk of atherosclerosis.年轻人与老年人颈动脉分叉几何结构的差异:对动脉粥样硬化几何风险的影响。
Stroke. 2005 Nov;36(11):2450-6. doi: 10.1161/01.STR.0000185679.62634.0a. Epub 2005 Oct 13.
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From Hippocrates to Palmaz-Schatz, the history of carotid surgery.
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