Tanburoglu Anıl, Andic Cagatay
Neurology, Başkent University, Adana, TUR.
Interventional Radiology, Faculty of Medicine, Baskent University, Adana, TUR.
Cureus. 2023 Oct 19;15(10):e47323. doi: 10.7759/cureus.47323. eCollection 2023 Oct.
We aimed to evaluate the efficacy and safety of graft stent implantation in the endovascular treatment of vascular injuries in the craniocervical area.
This study was carried out through the retrospective screening of eight (two females and six males) patients' records. Patients who used graft stents as an endovascular method were included in the study. The mean age of the patients was 43.6 years (with a range of 15-69 years). Due to different mechanisms, the patients had vascular injuries in the craniocervical region, and graft stent implantation was performed between 2010 and 2022. We evaluated patient demographics, admission symptoms, trauma mechanisms, angiographic findings, treatment modalities and materials, patient outcomes, and follow-up periods.
Due to iatrogenesis for four patients, penetrating trauma for three patients, and blunt trauma for one patient, injuries were present in the right internal carotid artery {ICA} (n=1), left ICA (n=1), left common carotid artery {CCA} (n=3), right CCA (n=1), right vertebral artery (n=1), and left vertebral artery (n=1). Angiographically, pseudoaneurysm was detected in seven patients, and vascular rupture was detected in one patient using contrast agent extravasation. All patients who underwent the endovascular method had technical success. Since bleeding from the external carotid artery branches was seen in two patients, these branches were embolized with coils. No radiologically or neurologically pathological findings were recorded during the follow-up period (with a range of one week to 12 years).
Graft stent use in the endovascular treatment of craniocervical vascular injuries is an operable, safe, and promising option, especially in patients with pseudoaneurysms and active bleeding.
我们旨在评估移植物支架植入术在颅颈区域血管损伤血管内治疗中的疗效和安全性。
本研究通过回顾性筛查8例（2例女性和6例男性）患者的记录进行。将使用移植物支架作为血管内治疗方法的患者纳入研究。患者的平均年龄为43.6岁（范围为15 - 69岁）。由于不同的机制，患者在颅颈区域发生血管损伤，并于2010年至2022年期间进行了移植物支架植入术。我们评估了患者的人口统计学资料、入院症状、创伤机制、血管造影结果、治疗方式和材料、患者预后以及随访时间。
4例患者因医源性损伤，3例患者因穿透性创伤，1例患者因钝性创伤，右侧颈内动脉（ICA）（n = 1）、左侧ICA（n = 1）、左侧颈总动脉（CCA）（n = 3）、右侧CCA（n = 1）、右侧椎动脉（n = 1）和左侧椎动脉（n = 1）出现损伤。血管造影显示，7例患者检测到假性动脉瘤，1例患者使用造影剂外渗检测到血管破裂。所有接受血管内治疗方法的患者均取得技术成功。由于2例患者出现来自颈外动脉分支的出血，这些分支用弹簧圈进行了栓塞。随访期间（范围为1周至12年）未记录到放射学或神经学病理结果。
移植物支架用于颅颈血管损伤的血管内治疗是一种可行、安全且有前景的选择，尤其是对于假性动脉瘤和活动性出血的患者。
