单纯血管内治疗颅外段颈内动脉瘤1例并文献复习

A case report and literature review of simple endovascular treatment of extracranial internal carotid aneurysm

探讨颅外段颈内动脉瘤的临床表现、分型及个体化治疗。回顾性分析1例颅外段颈内动脉瘤患者的临床资料,并对相关文献进行复习。患者为64岁男性,以“旋转性头晕伴四肢乏力1周”为主诉入院。既往高血压10年,控制不佳,无脑血管病史。术前影像学检查确诊为颅外段颈内动脉瘤。根据动脉瘤的部位、形态及颈内动脉和颈总动脉有无弯曲等情况,选择在全身麻醉下经股动脉行支架辅助栓塞术,手术过程顺利。术中及术后复查均显示左侧颈内动脉及其分支通畅,患者预后良好,未出现不良反应和并发症。颅外段颈内动脉瘤临床较罕见,其临床表现多样,既往以开放性手术治疗为主,但随着血管内介入的发展,针对颅外段颈内动脉瘤选择支架辅助介入栓塞治疗方案更有优势。

The clinical manifestation,classification and individualized treatment of extracranial internal carotid aneurysm were investigated.The clinical data of a patient with extracranial internal carotid aneurysm were analyzed retrospectively,and the relevant literatures were reviewed.A 64-year-old male was admitted to the hospital with the chief complaint of"rotational dizziness with limb weakness for 1 week".Hypertension was not well controlled for 10 years,and there was no history of cerebrovascular disease.In preoperative imaging examination,the patient was diagnosed as the extracranial internal carotid aneurysm.According to the location and shape of the aneurysm,whether the internal carotid artery and common carotid artery were bent or not,stent-assisted embolization was performed through femoral artery under general anesthesia,and the operation process was smooth.Intraoperative and postoperative reexamination showed that the left internal carotid artery and its branches were unobstructed,and the patient’s prognosis was good,with no adverse reactions and complications.Aneurysm of the extracranial segment of the internal carotid artery is rare in clinic,and its clinical manifestations are diverse.In the past,open surgery was the main treatment.However,with the development of endovascular intervention,it is more advantageous to choose stent-assisted interventional embolization for extracranial internal carotid artery aneurysms.