Ruptured internal carotid aneurysm resulting from neurofibromatosis: Treatment with intraluminal stent graft
Ruptured internal carotid aneurysm resulting from neurofibromatosis: Treatment with intraluminal stent graft
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DOI：
10.1067/mva.2000.107769
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发表时间：
2000-10-01
影响因子：
4.3
通讯作者：
Rivera, F
中科院分区：
文献类型：
--
作者：
Smith, BL;Munschauer, CE;Rivera, F
目的：这份报告显示了一种方法的治疗危及生命的出血，由于动脉瘤破裂，在颈内动脉颈神经纤维瘤病所造成的neurofibromatosis.Methods：10天后分娩的健康双胞胎，一个28岁的女子与已知的神经纤维瘤病突然大规模肿胀在左颈部。在最初的气管切开术后，血管造影证实了中颈颈内动脉破裂以及颈外动脉分支导致的假性动脉瘤。治疗开始于颈外动脉分支的弹簧圈栓塞。然后通过使用两个支架移植物闭合颈内动脉病变（长度约1厘米的缺陷），每个支架移植物均由Palmaz支架和预扩张至6毫米的3毫米聚四氟乙烯移植物制成。然后通过手术清除颈部血肿。结果：完成血管造影和计算机断层扫描证实出血得到控制。除了出血引起的颅神经缺损外，患者的神经功能完好无损。术后3周取出气管切开管。结论：神经纤维瘤病是一种少见的血管囊性变的病因。颈段颈内动脉破裂动脉瘤的修复虽然可行，但很难用覆膜支架修复;然而，这是一个比手术介入更好的选择。
Purpose: This report shows a method of treatment for life-threatening hemorrhage due to rupture of an aneurysm in the cervical internal carotid artery caused by neurofibromatosis.Methods: Ten days after delivery of healthy twins, a 28-year-old woman with known neurofibromatosis had sudden massive swelling in the left neck. After initial tracheostomy, angiography confirmed rupture of the mid cervical internal carotid artery as well as contribution to the resultant pseudoaneurysm from external carotid branches. Treatment began with coil embolization of the external carotid branches. The internal carotid lesion, a defect approximately I cm in length, was then closed through use of two stent grafts, each made from Palmaz stents and 3-mm polytetrafluorethylene grafts predilated to 6 mm. The neck hematoma was then evacuated surgically.Results: Completion angiography and computed tomographic scanning confirmed control of the hemorrhage. The patient survived neurologically intact with the exception of cranial nerve deficits caused by the hemorrhage. The tracheostomy tube was removed 3 weeks postoperatively. follow-up computed tomographic scanning showed a gradual decrease in the size of the cervical soft tissue and no recurrent aneurysm.Conclusion: Neurofibromatosis is a rare cause of aneurysmal degeneration of blood vessels. Repair of a ruptured cervical internal carotid artery aneurysm, though feasible, is difficult with stent grafts; however, this is a better option than surgical intervention in inaccessible vessels.