颈内动脉闭塞术的初步临床应用

目的探讨颈内动脉闭塞术治疗颈内动脉血管性病变的价值。方法共5例患者,1例鼻咽癌行放疗后清创术,并发难以制止的鼻咽部大出血,双侧后鼻孔填塞无效;1例巨大颈内动脉眼段动脉瘤,无法手术夹闭;3例外伤后颈内动脉海绵窦瘘,单纯闭塞瘘口失败。采用Seldinger技术经股动脉穿刺置管行全脑血管造影,经球囊闭塞试验或病变侧压颈试验,病人耐受良好后方行闭塞术。闭塞材料为3例应用可脱弹簧圈,2例应用可脱球囊,闭塞位置为病变近端及瘘口。结果所有病例闭塞颈内动脉后,即行对侧颈动脉造影复查,可见前交通动脉和/或后交通动脉代偿良好,患者无明显并发症发生,病变未见显影。临床症状消失、无合并症发生,病变未见复发。结论颈内动脉闭塞术作为一种治疗颈动脉血管性疾病的方法,可以在不危及病人生命、加重病人病情的情况下,取得良好的治疗效果。

Primary clinical application of occlusion in internal carotid artery

Objective To investigate the efficiency of transcatheter internal carotid artery (ICA) occlusion. Methods There were five patients underwent transcatheter ICA occlusion, aged from 15 to 55 years. One patient suffered uncontrol nasopharyn bleed after nasopharyn carcinoma radio-treatment detriment. One was giant carotid-optic aneurysm and could not clip the aneurysm. Three patients of huge tramatic carotid-cavernous fistula were not able to close the fistula with preservation ICA. All patients suffered succeed occlusion test. The occlusion materials were coils (3 patients) and balloons (2 patients). Results All patients took contralateral carotid artery angiography after the procedure and showed well compensation from the anterior communicating artery or/and posterior communicating artery. There were no complications, and the lesions did not display. Conclusion Transcatheter ICA occlusion showed good effects in the treatment of ICA vessel disease.