Llorente A, Bronte E, Ramos G, Carpintero M, Giménez C
Servicio de Anestesiología y Reanimación, Complejo Hospitalario de León.
Rev Esp Anestesiol Reanim. 1995 Oct;42(8):341-3.
Extracranial mycotic aneurysms of the carotid are unusual. We present such an aneurysm of the right primary carotid caused by enteritis due to Salmonella in a 75-year-old patient at high risk for surgery (myocardial ischemia evolving over 3 months) and with coexisting stenosis of 75% of the left internal carotid. Endarterectomy of the left internal carotid, with shunting, was performed, after which the right primary carotid was tied during the same operation. Epidural anesthesia to C6-C7 was provided through a catheter supplemented with an intravenous propofol infusion. Neurological and hemodynamic variables monitored during surgery were stable. No neurological deficits or myocardial ischemic changes were recorded. Three months after discharge the patient was asymptomatic.
颈动脉颅外霉菌性动脉瘤并不常见。我们报告了一名75岁患者,其右颈总动脉出现此类动脉瘤,病因是沙门氏菌引起的肠炎。该患者手术风险高(心肌缺血已持续3个月),且左颈内动脉存在75%的狭窄。对左颈内动脉进行了内膜切除术并使用分流术,在此期间的同一手术中结扎了右颈总动脉。通过导管并辅以静脉注射丙泊酚进行C6 - C7硬膜外麻醉。手术过程中监测的神经和血流动力学变量稳定。未记录到神经功能缺损或心肌缺血变化。出院三个月后患者无症状。