Marotta T R, Buller C, Taylor D, Morris C, Zwimpfer T
Department of Radiology, Vancouver Hospital and Health Sciences Center, University of British Columbia, Canada.
Neurosurgery. 1998 Feb;42(2):408-12; discussion 412-3. doi: 10.1097/00006123-199802000-00138.
Stenting of a cervical internal carotid pseudoaneurysm is presented using a stent covered with saphenous vein. This procedure resulted in immediate exclusion of the aneurysm and maintained patency of the carotid artery.
A gunshot to the neck resulted in airway obstruction and respiratory arrest with neurological injury in a male patient. Angiographic investigation revealed an enlarging cervical internal carotid pseudoaneurysm, possibly the source of a cerebral embolism. Anticoagulation had to be stopped because of bleeding complications. A decision was made to conduct definitive percutaneous treatment of the pseudoaneurysm.
A Palmaz stent (JJIS, Warren, NJ) was covered with saphenous vein harvested from the patient's leg. Using standard technique and a simple innovation for stent construct introduction into the sheath, the vein-covered stent was placed across the opening of the aneurysm and dilated into position with a balloon.
Immediate exclusion of a cervical internal carotid pseudoaneurysm was performed using an autologous vein-covered stent. One-month follow-up confirmed continued exclusion of the pseudoaneurysm and carotid patency without stenosis.
本文介绍了使用隐静脉覆盖支架治疗颈内动脉假性动脉瘤的方法。该手术立即封闭了动脉瘤，并保持了颈动脉的通畅。
一名男性患者颈部枪伤导致气道阻塞、呼吸骤停及神经损伤。血管造影检查发现颈内动脉假性动脉瘤不断增大，可能是脑栓塞的来源。由于出血并发症，抗凝治疗不得不停止。决定对假性动脉瘤进行确定性经皮治疗。
用从患者腿部采集的隐静脉覆盖Palmaz支架（JJIS，沃伦，新泽西州）。采用标准技术并对将支架结构引入鞘管的方法进行了一项简单创新，将静脉覆盖支架置于动脉瘤开口处，并用球囊扩张到位。
使用自体静脉覆盖支架立即封闭了颈内动脉假性动脉瘤。1个月的随访证实假性动脉瘤持续封闭，颈动脉通畅无狭窄。
