血管腔内治疗创伤性后交通动脉假性动脉瘤伴海绵窦瘘

Endovascular treatment for traumatic posterior communicating artery pseudoaneurysm associated with cavernous sinus fistula

目的探讨创伤性后交通动脉假性动脉瘤伴海绵窦瘘的血管造影表现及血管腔内介入治疗的可行性。方法回顾1例创伤性后交通动脉假性动脉瘤伴海绵窦瘘患者的临床诊疗过程。结合Pubmed数据库文献,分析该病临床、病理特点及治疗策略。结果创伤性后交通动脉假性动脉瘤破裂危害极大,可引起蛛网膜下腔出血和海绵窦瘘,治疗难度增加。血管腔内介入栓塞治疗后交通动脉假性动脉瘤是首要和推荐方法,同时可达到海绵窦瘘微创治疗的目的。结论脑血管造影可完善创伤性颅内假性动脉瘤诊断,随后的血管腔内介入栓塞可为该病提供治疗机会。

Objective To investigate the angiographic features of traumatic posterior communicating artery pseudoaneurysm associated with cavernous sinus fistula,and to discuss the feasibility of endovascular intervention for its treatment.Methods The clinical process of diagnosis and treatment in a patient with traumatic post-trauma pseudoaneurysm complicated by cavernous sinus fistula was retrospectively reviewed.By reviewing the literature from Pubmed database,the analysis of the clinical manifestations,pathological features and treatment strategies of this disease were conducted.Results The rupture of traumatic posterior communicating artery pseudoaneurysm was extremely dangerous,which could cause subarachnoid hemorrhage and cavernous sinus fistula,thus,increasing the difficulty of its treatment.Transarterial endovascular embolization of posterior communicating artery pseudoaneurysm was the primary and recommended method,which could simultaneously achieve the purpose of minimally-invasive treatment for cavernous sinus fistula.Conclusion For traumatic intracranial pseudoaneurysm,cerebral angiography can reliably improve its diagnosis,and the subsequent endovascular embolization can promptly provide it with effective treatment.(J Intervent Radiol,2020,29:1036-1039)