Neelakandhan K S, Matta R
Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology Trivandrum, Kerala, India.
Int Angiol. 1996 Dec;15(4):316-20.
This article reviews the etiology, clinical manifestations, operative techniques, and results of management of fourteen cases of extracranial carotid artery aneurysms, operated upon in our institution between September 1990 and August 1994. Except for one, they were elective operations. Aneurysmectomy with restoration of continuity by direct anastomosis was done in four cases, an autogenous saphenous vein graft was performed in one, and prosthetic grafts (Dacron) in three. Local conditions precluded restoration of arterial continuity in two cases. Two patients underwent exclusion and bypass graft, and one underwent exclusion only. Ligation was resorted to in one patient, who was subjected to emergency surgery due to rupture of the aneurysm. A temporary, intra-operative, extraluminal carotid artery shunt was used in only one patient, as all the others had angiographic evidence of satisfactory cerebral cross-circulation. Two patients developed transient, neurological deficits in the post-operative period. There was no mortality. We conclude that aneurysms of the extracranial carotid arteries can be operated on with minimal morbidity and no mortality. Operative management is the treatment of choice because of their potential neurological complications, if left untreated.
本文回顾了1990年9月至1994年8月间在我院接受手术治疗的14例颅外颈动脉动脉瘤的病因、临床表现、手术技术及治疗结果。除1例急诊手术外，其余均为择期手术。4例行动脉瘤切除术并直接吻合重建血管连续性，1例行自体大隐静脉移植术，3例行人工血管（涤纶）移植术。2例因局部情况无法重建动脉连续性。2例患者接受了血管旷置及搭桥术，1例仅接受了血管旷置术。1例因动脉瘤破裂接受急诊手术的患者采用了结扎术。仅1例患者术中使用了临时性的腔外颈动脉分流管，因为其他患者血管造影显示脑侧支循环良好。2例患者术后出现短暂性神经功能缺损。无死亡病例。我们得出结论，颅外颈动脉动脉瘤手术可将发病率降至最低且无死亡风险。由于未经治疗可能引发神经并发症，手术治疗是首选的治疗方法。
