颈内动脉巨大蛇形动脉瘤的血管内治疗

Endovascular treatment of giant serpentine aneurysm of internal carotid artery

目的 :描述颈内动脉巨大蛇形动脉瘤 (giantserpentineaneurysm ,GSA)的影像学特征 ,探讨血管内治疗的有效性。方法 :对 1例颈内动脉GSA行颈内动脉可脱性球囊栓塞治疗。结果 :本病例CT显示不规则的梨形巨大不均匀高密度占位 ,外围不连贯的蛋壳样钙化影 ,局部骨质破坏 ,增强扫描显示不均匀强化 ;数字减影血管造影显示蛇形血管通道、流入口、流出口、正常远端动脉 ,行血管内球囊栓塞治疗 ,随访 2个月无异常表现。结论 :GSA具有特异的影像学特征 ,预后差 ,必须积极治疗 。

Objective:To describe the imaging features of giant serpentine aneurysm(GSA) of internal carotid artery and discuss the efficacy of its endovascular treatment.Methods:One case of GSA was performed emboloic therapy,with detachable balloon.Results:An irregular,pear shaped,massive lesion of high density and with an uncontinous egg shell shaped calcified image on the periphery was found in CT.Local bone substance was destroyed.Irregular intensification was found in intensified CT scan.Snaky vessel channel,flow in and flow out entrance,normal remote artery were found in DSA.Intravascular embolization with detachable balloon was employed and the follow up lasted for 2 months.The patient felt comfortable.Conclusions:GSA has distinctive imaging features.The prognosis of it is poor.So it is necessary to give GSA aggressive management.The endovascular occlusion with balloon is a safe and effective method for treatment of GSA.