Willis覆膜支架治疗颈内动脉海绵段假性动脉瘤与瘘

目的 探讨使用Willis覆膜支架治疗颈内动脉海绵窦段假性动脉瘤与瘘的可行性、有效性。方法 回顾性分析2013年1月到2017年12月收治的15例颈内动脉海绵窦段假性动脉瘤和1例颈内动脉海绵窦瘘的临床资料，均采用Willis覆膜支架置入术治疗。结果 术后即刻血管造影显示病变完全消失，载瘤动脉通畅。术后死亡2例；其余14例术后随访6~24个月，均恢复正常工作，DSA或CTA随访未见复发，但1例放疗病人出现颈内动脉海绵窦段慢性闭塞。结论 Willis覆膜支架治疗颈内动脉海绵窦段假性动脉瘤与瘘成功率高，操作简单。

Treatment of pseudoaneurysms and fistulas of internal carotid arteries cavernous segments with covered stent-graft

Objective To investigate the feasibility and efficacy of the treatment of pseudoaneurysms and fistulas of internal arteries cavernous segment (ICACS) with the covered stent-graft. Methods The clinical data of 16 patients with pseudoaneurysms and fistulas of ICACS treated with covered stent-graft in recent 5 years were analyzed retrospectively. Of these 16 patients, 15 suffered from ICACS pseudoaneurysms and 1 from ICAS fistula. Results DSA immediately after the operation sowed that the pseudoneurysms and fistula disappeared completely and the parent arteries were free in all the patients. Two patients died of intracranial rebleeding respectively 3 and 10 days after the operation. The following-up from 3 to 24 months showed that all the surviving patients returned to normal work. DSA or CTA examination showed that no lesions recurred in 14 patients, but the internal carotid cavernous sinus was occluded after the stenting in 1 patients associated with nasopharyngeal carcinoma treating by radiotherapy. Conclusions The covered stent-graft is a safe and effective method to treat the ICACS hemorrhages caused by pseudoaneurysms and fistulas, but its effect should be confirmed by the long-term following up and the application of it to treatment of the more same patients.