Tubridge血流导向装置治疗外伤性颈内动脉假性动脉瘤一例

Endovascular treatment of a traumatic carotid pseudoaneurysm with the Tubridge stent: a case report

外伤性颅内假性动脉瘤常由头部钝器伤或穿透伤造成,缺少真正的血管壁,仅有脆弱的结缔组织层覆盖,其主要发生于颈内动脉颈段、海绵窦段和岩骨段。作者报道Tubridge血流导向装置成功治疗车祸后颈内动脉假性动脉瘤患者1例。患者32岁,男性,车祸后诊断左侧颈内动脉假性动脉瘤,伤后近1个月行Tubridge血流导向装置置入术治疗,支架释放后造影可见假性动脉瘤内对比剂明显滞留,瘤体显影缩小,支架打开良好。术后第4天MR血管成像复查可见假性动脉瘤缩小,术后10d复查DSA,假性动脉瘤进一步缩小,术后4个月DSA随访,显示动脉瘤完全不显影。

Traumatic intracranial pseudoaneurysm is usually caused by blunt or penetrating head injuries.It lacks of real blood vessel wall and is covered only by a fragile connective tissue layer.Traumatic intracranial pseudoaneurysm mainly occurs in the carotid,cavernous and petrous segments of the internal carotid artery.A case of traumatic internal carotid artery pseudoaneurysm successfully treated with Tubridge flow diverter device was reported.The 32-year-old male patient was diagnosed as a pseudoaneurysm of the left internal carotid artery after a traffic accident,and received treatment with Tubridge flow diverter device one month later.After stents release,angiography showed obviously retained contrast agent in pseudoaneurysm,decreased aneurysm size and well-opened stents.The size of the pseudoaneurysm was found reduced by magnetic resonance angiography reexamination on the 4th day after the operation,and a further decrease on the 10th day by digital subtraction angiography(DSA) reexamination.Four months after the operation,DSA showed the aneurysm was completely cured.