外伤性颈内动脉海绵窦段假性动脉瘤血管内栓塞治疗

目的：探讨外伤性颈内动脉海绵窦段假性动脉瘤血管内栓塞治疗的方法和疗效。方法：5例颈内动脉海绵窦段假性动脉瘤，其中的4例宽颈假性动脉瘤先植入冠脉孔支架覆盖动脉颈，再将微导管通过支架网孔超选进入动脉瘤腔，填塞电解可脱卸弹簧圈（GDC）；另1例窄颈假性动脉瘤单纯行GDC填塞。结果：所有动脉瘤均成功治疗，动脉瘤填塞均在95％以上，1例宽颈假性动脉瘤行支架结合GDC治疗后复发，经再次填塞GDC后治愈，1随访5－18个月，载瘤动脉通畅，临床效果优良。结论：从本组资料看，窄颈和宽颈假性动脉瘤可分别采用GDC栓塞和血管内支架结合GDC栓塞治疗，血管内支架结合GDC栓塞治疗颈内动脉假性动脉瘤是安全、有效的方法，长期疗效有待进一步随访。

Endovascular therapy of traumatic pseudoaneurysms in cavernous segment of internal carotid artery

Objective: To summarize our clinical experience on treatment of traumatic internal carotid artery(ICA) cavernous segment pseudoaneurysms with endovascular stent and Guglielmi detachable coils(GDCs) or GDCs alone.Methods: Five traumatic pseudoaneurysms of cavernous segment of ICA were treated.The coronary stents were implanted across the neck of 4 wide necked pseudoaneurysms.Microcatheters were introduced into the pseudoaneurysm sac through stent mesh,GDCs were used to embolize aneurysms.One pseudoaneurysm was embolized with GDCs alone.Results: All operation were successful.Occlusion rates of all pseudoaneurysms were over 95%.The patients recovered well with patency of the parent arteries.One patient with recurrence was treated with GDC again and recovered well.Conclusion: Endovascular therapy with stent implantation and GDC placement or GDC placement alone is safe and effective in treatment of traumatic ICA cavernous segment pseudoaneurysms.