Willis覆膜支架治疗外伤性颈内动脉假性动脉瘤的中期随访  

Treatment of traumatic internal carotid artery pseudoaneurysms with Willis covered stents:a mid-term followup result

作　　者：王武[1] 李明华[1] 李永东[1] 顾斌贤[1] 方淳 谭华桥[1] 王珏[1] 张培蕾[1] 

机构地区：[1]上海交通大学附属第六人民医院放射科,200233

出　　处：《介入放射学杂志》2010年第4期257-261,共5页Journal of Interventional Radiology

摘　　要：目的评价Willis覆膜支架治疗外伤性颈内动脉假性动脉瘤的疗效和中期预后。方法在38例头颈部外伤患者的脑血管造影中发现了13例、14枚延迟性颈内动脉假性动脉瘤,所有假性动脉瘤使用Willis覆膜支架治疗,术后1、3、6和12个月随访脑血管造影,分为完全闭塞和不完全闭塞;临床症状随访分为完全恢复、明显改善、无明显改善和恶化。结果所有病例成功植入Willis覆膜支架,术中无一例出现并发症。最初9例假性动脉瘤完全闭塞,4例不完全闭塞;3～12个月随访造影显示12例假性动脉瘤完全闭塞,所有病例颈内动脉通畅,无明显支架内狭窄。临床随访11例完全恢复,1例改善,1例无明显改善;无致残和致死病例。结论Willis覆膜支架治疗外伤性颈内动脉假性动脉瘤是切实可行的,能够很好地保留载瘤动脉。Objective To evaluate the efficacy and mid-term follow-up results of endovascular treatment with Willis covered stent for traumatic pseudoaneurysms located in the internal carotid artery（ICA）.Methods ICA angiography was performed in 38 patients with traumatic brain and neck injury.Of the 38 patients,13 delayed traumatic pseudoaneurysms were found.All the pseudoaneurysms were treated with Willis covered stents.Follow-up angiography was performed at 1,3,6 and 12 months after the procedure,and the results were categorized as complete or incomplete occlusion.Clinical manifestations were graded as full recovery,improvement,unchanged and aggravation.Results Willis covered stent placement was technically successful in all traumatic pseudoaneurysms.No procedure-related complications occurred.The initial angiographic results showed a complete occlusion in 9 patients,and an incomplete occlusion in 4.The angiographic follow-up within 3-12 months exhibited a complete occlusion in 12 patients and the parent arteries remained patency in all patients.The clinical follow-up observation demonstrated that full recovery was obtained in 11 patients,clinical improvement in one,and unchanged condition in one.No morbidity or mortality occurred.Conclusion Willis covered stent implantation is a feasible and practical treatment for traumatic pseudoaneurysms located in the ICA.This technique can well preserve the parent artery with excellent therapeutic results.

关 键 词：创伤性脑损伤 假性动脉瘤 Willis覆膜支架 颈内动脉 

分 类 号：R743.4[医药卫生—神经病学与精神病学]