Extracranial internal carotid artery aneurysms: Results of a surgical series with long-term follow-up
Extracranial internal carotid artery aneurysms: Results of a surgical series with long-term follow-up
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DOI：
10.1016/s0741-5214(96)80037-1
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发表时间：
1996-04-01
影响因子：
4.3
通讯作者：
DAddato, M
中科院分区：
文献类型：
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作者：
Faggioli, G;Freyrie, A;DAddato, M
目的：本研究的目的是分析一系列颅外颈内动脉动脉瘤（EICA.Methods）的表现模式，手术治疗，以及早期和长期的结果：回顾性分析所有的情况下，治疗EICAA在一个单一的机构从1974年3月至1995年3月。患者随访获得了一个监督协议，术后3个月和每年afters.Results：24 EICAA在20例患者进行了治疗，在21年的时间内进行了双重扫描。原因是12例（50%）纤维肌性发育不良，9例（37.5%）非特异性“动脉粥样硬化”，2例（8.3%）既往颈动脉手术，1例（4.1%）创伤。共有9例（37.5%）出现神经系统症状，其中7例（29.1%）为半球性症状，2例（8.3%）为非半球性症状。手术技术是在接受全身麻醉的患者中进行的，包括动脉瘤切除和颈内动脉再吻合术（8例[33.3%]）或再次植入颈外动脉1例（4.1%）;间置移植物（10例[41.6%]，7条静脉，3例（12.5%）行单纯腹壁切除术，3例（12.5%）行补片修补，2例（8.3%）不补片修补。22例患者接受了择期手术，死亡率为0%，中风率为4.5%。在2例破裂动脉瘤（1例自发性和1例医源性）中进行了紧急手术; 1例患者（50%）死亡。颅神经病变发生在5例（20.8%）。平均随访时间为96.7 +/- 88.15个月（范围4至240个月），包括隐静脉移植物中7例并发症中的2例（28%），1例（4.1%）晚期短暂性脑缺血发作，以及19年后动脉瘤复发。结论：EICAA引起的症状和潜在并发症提示广泛的手术适应症。EICAA可以安全治疗，因为早期和长期效果良好。
Purpose: The purpose of this study was to analyze mode of presentation, surgical treatment, and early and long-term results of a series of extracranial internal carotid artery aneurysms (EICAA).Methods: A retrospective analysis was performed on all cases treated for EICAA in a single institution from March 1974 to March 1995. Patient follow-up was obtained by a surveillance protocol, with duplex scanning performed 3 months after surgery and yearly thereafter.Results: Twenty-four EICAA in 20 patients were treated over a 21-year period. The cause was fibromuscular dysplasia in 12 cases (50%), nonspecific ''atherosclerosis'' in nine (37.5%), previous carotid artery surgery in two (8.3%), and trauma in one case (4.1%). Neurologic symptoms were present in a total of nine cases (37.5%) and were hemispheric in seven (29.1%) and nonhemispheric in two (8.3%). Operative techniques were performed with patients receiving general anesthetic and included aneurysm excision with internal carotid artery reanastomosis (8 cases [33.3%]) or reimplantation onto the external carotid artery (1 case [4.1%]); interposition graft (10 cases [41.6%], 7 veins, 3 polytetrafluoroethylene) or simple aneurysmectomy and closure of the wall defect either with (3 cases [12.5%]) or without (2 cases [8.3%]) a patch. Elective surgery was performed in 22 cases, with a 0% mortality rate and 4.5% stroke rate. Emergency operations were performed in two cases of ruptured aneurysms (one spontaneous and one iatrogenic); one patient (50%) died. Cranial nerve morbidity occurred in five cases (20.8%). Mean follow-up was 96.7 +/- 88.15 months (range 4 to 240 months) and included 2 of 7 (28%) complications in saphenous vein grafts, 1 (4.1%) late transient ischemic attack, and a recurrent aneurysm after 19 years.Conclusions: Symptoms and potential complications caused by EICAA suggest a broad surgical indication. EICAA can be treated safely because of the good early and long-term results.