Arzola Luis H, Mani Kevin, Zuccon Gianmarco, Ekberg Tomas, Wanhainen Anders
Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
J Vasc Surg Cases Innov Tech. 2023 Mar 20;9(2):101161. doi: 10.1016/j.jvscit.2023.101161. eCollection 2023 Jun.
Extracranial carotid artery aneurysms (CAAs) are extremely rare and often require surgical intervention to avoid complications such as local compression symptoms and thrombo-embolization. We present the case of a 63-year-old man with a history of hypertension, meningioma, and an incidental finding of a right saccular internal carotid artery aneurysm at the base of the skull. He underwent open surgical repair; nonetheless, end-to-end anastomosis was not feasible. As bailout, the internal carotid artery was successfully reconstructed with a novel Viabahn-assisted sutureless anastomosis technique (GORE, Viabahn). Postoperative clinical assessment revealed no complications, postoperative computed tomography angiography revealed a patent reconstruction, and the patient was discharged home uneventfully with 1-year clinical and computed tomography angiography follow-up without remarks. Hybrid procedure is a viable option for technically challenging carotid anastomoses near the skull base.
颅外颈动脉动脉瘤（CAA）极为罕见，通常需要手术干预以避免诸如局部压迫症状和血栓栓塞等并发症。我们报告一例63岁男性病例，其有高血压、脑膜瘤病史，偶然发现颅底右侧囊状颈内动脉瘤。他接受了开放手术修复；然而，端端吻合不可行。作为补救措施，采用一种新型的Viabahn辅助无缝合吻合技术（戈尔公司，Viabahn）成功重建了颈内动脉。术后临床评估未发现并发症，术后计算机断层扫描血管造影显示重建血管通畅，患者顺利出院，进行了1年的临床和计算机断层扫描血管造影随访，无异常情况。对于颅底附近技术上具有挑战性的颈动脉吻合，杂交手术是一种可行的选择。
