创伤性颅内段颈内动脉假性动脉瘤的血管内治疗

目的:探讨创伤性颅内段颈内动脉假性动脉瘤的血管内治疗方法及效果。方法:采用GDC栓塞或注射NBCA胶灌注假性动脉瘤腔、采用可脱式球囊或弹簧栓子闭塞载瘤动脉及载瘤动脉内支架置入。结果:17例假性动脉瘤均治愈,仅1例载瘤动脉闭塞后因严重贫血发生脑梗塞而遗留轻度神经功能缺失。结论:脑血管造影是确诊和研究该病唯一可靠的手段;经血管内栓塞治疗创伤性颅内颈内动脉假性动脉瘤操作简单、损伤小、安全、有效;采用注射NBCA胶灌注假性动脉瘤腔及封闭动脉漏口的效果需进一步观察与探讨;血容量减少及低血红蛋白在行载瘤动脉闭塞时确定脑血流代偿能力的诸因素中具有重要意义。

Discussion about endovascular treatment for traumatic intracranial pseudoaneurysms of internal carotid artery

Objective:To discuss the method and result of endovascular treatment for traumatic intracranial pseudoaneurysms of internal carotid artery.Methods:To fill the cavity with GDC or inject NBCA into the cavity of the pseudoaneurysms,occlude the parent artery with detachable balloon or coil,implant stent into the parent artery.Results:All the pseudoaneurysms in 17 cases were all cured,and brain infarction occurred in 1 case because of anaemia after occlusion of the parent artery.(Conclusion:DSA) of brain is the only trustable means to diagnose and study the disease.Endovascular treatment for traumatic intracranial pseudoaneurysms of internal carotid artery is a simple,minimal traumatic,secure and effective method.The effect of the injection of NBCA into the cavity of pseudoaneurysms need more observation and discussion.Of all the factors that can estimate the compensative capability of cerebral blood flow,hypovolemia and hypochromic were very important while deciding to occlude the parent artery.