创伤性颈动脉假性动脉瘤病因及诊治探讨

目的对创伤性颈动脉假性动脉瘤病因及血管内栓塞治疗进行探讨。方法对26例患者行数字减影血管造影术(DSA)检查明确诊断，同时行血管内栓塞治疗。5例采用微弹簧圈栓塞，19例采用可脱性球囊行假性动脉瘤开口处颈动脉闭塞，2例采用10％α-氰基丙烯酸正丁酯(NBCA)脑膜中动脉供支栓塞。结果20例栓塞后鼻腔出血停止，其中1例视力下降栓塞后1周视力好转。3例头痛3周后消失。3例颈部包块杂音消失、质软、无搏动。1例死亡。随访6-12个月无一例再次出血，颈部包块消失。结论血管内栓塞是治疗创伤性颈动脉假性动脉瘤有效的方法。

Etiology and diagnosis of traumatic false aneurysms of the carotid artery

Objective To discuss diagnosis and endovascular treatment of traumatic false aneurysms of the carotid artery. Methods A total of 26 cases of traumatic false aneurysms were diagnosed with digital subtraction angiography (DSA) and treated by endovascular embolization. Of all, five cases were embolized with microcoil, 19 with balloon test occlusion of the internal carotid artery and two occlusion of the middle meningeal artery by using 10% NBCA. Results Posterior to embolization, bleeding of nasal cavity stopped in 20 cases, vision improved in one case one week after embolization, headache disappeared in three cases three weeks after embolization, cervical mass resulted in murmur vanishing and changes soft without pulsation, and one died. The follow up for 6-12 months showed no bleeding or cervical mass. Conclusion Endovascular treatmentis the best way for traumatic false aneurysms of the carotid artery.