颅外段颈动脉破裂的血管内介入治疗

目的:评价介入技术经血管内治疗颅外段颈动脉破裂的安全性和疗效。方法:对6例经数字减影血管造影(digital subtraction angiography,DSA)确诊的颅外段颈动脉破裂患者进行血管内治疗,其中采用覆膜支架封闭颈动脉破裂口4例,弹簧圈闭塞颈动脉2例。结果:血管造影显示颈总动脉(CCA)破裂出血5例,颅外段颈内动脉(ICA)动静脉瘘(AVF)1例,治疗均获成功,颈动脉保留通畅4例,全部病例临床症状消失。无并发症及死亡病例。术后随访1~16月,均无临床症状复发(其中1例在4月后死于肿瘤晚期)。结论:经导管栓塞-覆膜支架置入治疗颅外段颈动脉破裂损伤小、安全、有效。

Endovascular interventional treatment for the rupture of extracranial segment of carotid artery

Objective: To evaluate the efficacy and safety of the endovascular interventional minimally invasive techniques(IMIT) for treatment of rupture of extracranial segment of carotid artery.Methods: 6 cases with rupture of extracranial segment of carotid artery diagnosed by digital subtraction angiography(DSA) were treated with IMIT.Among them 4 cases were underwent transcatheter stent-graft placement to obturate the rupture of carotid artery and 2 cases underwent transcatheter embolization with coils of ruptured carotid artery.Results: Angiography demonstrated rupture of extracranial segment of carotid artery and bleeding in 5 cases,and arteriovenous fistula(AVF) at the neck in 1 case.All the cases gained successful procedure and there is no complication or mortality in the study.During the follow-up for 1 to 16 months,no symptom re-occurred(one case died of advanced cancer of neck 4 months later).Conclusion: Transcatheter embolization and stent-graft placement are tiny invasion,safe and effective methods in the treatment for rupture of extracranial segment of carotid artery.