颅外段颈动脉破裂的血管内介入治疗

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

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。

Objective： To evaluate the efficacy and safety of the endovascular interventional minimally invasive techniques （IMIT） for treatment of rupture of extraeranial 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 eases, 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.