Wang Tao, Wu Yaqin, Wang Jingjing, Yu Dongzhen, Shi Haibo, Chen Zhengnong, Wang Pengjun, Yin Shankai
Department of Skull Base Surgery Center，Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，Shanghai，200233，China.
Department of Otolaryngology Head and Neck Surgery，Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Sep;38(9):797-801. doi: 10.13201/j.issn.2096-7993.2024.09.004.
To summarize the application of internal carotid artery stent in glomus jugular paraganglioma surgery, and to provide an effective strategy for reducing the risk of internal carotid artery injury. This article reviewed the surgical cases of internal carotid artery stent implanting from 2018.06 to 2022.12, and discussed the stent placement method, treatment protocols, and perioperative management strategies. A total of 5 patients underwent a comprehensive evaluation of the degree of internal carotid artery invasion using imaging techniques such as MRI, carotid CT angiography （CTA）, and digital silhouette angiography （DSA）. All patients were found to have varying degrees of internal carotid artery involvement. Stenting of the internal carotid artery was performed in all patients before surgery, and the stenting process went smoothly without any internal carotid artery injury. Three months after stenting, tumor resection or subtotal resection surgery was performed to avoid internal carotid artery injury during the surgery, and the surgical process was successfully completed. Postoperative follow-up from 4 months to 2 years showed that the internal carotid artery was patent after stent placement, with great endothelialization process and no stent-related complications. In patients with glomus jugular paraganglioma, when preoperative imaging shows internal carotid artery involvement, preoperative stenting is a safe and effective therapeutic strategy to reinforce the arterial wall structure, protect and maintain the integrity of the artery, and reduce the risk of vascular injury during the surgery. This article summarizes the experience of internal carotid artery stent in glomus jugular paraganglioma surgery, which provides an important reference for clinical practice.
总结颈内动脉支架在颈静脉球副神经节瘤手术中的应用，为降低颈内动脉损伤风险提供有效策略。本文回顾了2018年6月至2022年12月颈内动脉支架植入的手术病例，探讨了支架置入方法、治疗方案及围手术期管理策略。共有5例患者采用MRI、颈动脉CT血管造影（CTA）和数字剪影血管造影（DSA）等成像技术对颈内动脉侵犯程度进行了综合评估。所有患者均发现有不同程度的颈内动脉受累。所有患者均在手术前行颈内动脉支架置入，置入过程顺利，无颈内动脉损伤。支架置入3个月后，行肿瘤切除或次全切除手术，术中避免颈内动脉损伤，手术过程顺利完成。术后4个月至2年的随访显示，支架置入后颈内动脉通畅，内皮化进程良好，无支架相关并发症。对于颈静脉球副神经节瘤患者，术前影像学显示颈内动脉受累时，术前支架置入是一种安全有效的治疗策略，可强化动脉壁结构，保护和维持动脉完整性，降低手术中血管损伤风险。本文总结了颈内动脉支架在颈静脉球副神经节瘤手术中的经验，为临床实践提供了重要参考。
