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目的探讨覆膜支架腔内修复术治疗颈动脉假性动脉瘤破裂出血的效果及安全性。方法回顾性分析2009年7月至2015年7月中山大学孙逸仙纪念医院采用血管内覆膜支架植入术急诊救治的15例颈动脉假性动脉瘤破裂出血患者。其中直接外伤致颈总动脉假性动脉瘤1例,颈部手术致颈总动脉假性动脉瘤破裂1例,致颈内动脉假性动脉瘤破裂3例,鼻咽癌放疗后颈内动脉假性动脉瘤破裂10例。结果 15例患者均经覆膜支架腔内修复术得到成功救治,无即刻手术相关并发症及死亡发生。术后平均随访时间11个月,15例患者均无再次出血,临床随访期间无脑缺血并发症。结论覆膜支架腔内修复术治疗颈动脉假性动脉瘤破裂出血创伤小、安全有效,可在封堵颈动脉破口的同时恢复头颈部正常血供,并发症少。但仍需更大样本量临床研究证实,进一步观察远期疗效。
Objective To investigate the effect and safety of endovascular stent-graft for the treatment of ruptured hemorrhage of pseudoaneurysm of carotid artery. Methods A retrospective analysis of 15 patients with carotid pseudoaneurysm rupture hemorrhage treated with endovascular stent-graft in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from July 2009 to July 2015 was retrospectively analyzed. One case of direct injury to the common carotid artery pseudoaneurysm in 1 case, neck surgery caused by common carotid artery aneurysm rupture in 1 case, caused by internal carotid artery pseudoaneurysm rupture in 3 cases, nasopharyngeal carcinoma after radiotherapy of internal carotid artery leave Aneurysm rupture in 10 cases. Results All 15 patients underwent endovascular stent-graft repair without any immediate complications and death. After an average follow-up of 11 months, 15 patients had no rebleeding and no cerebral ischemic complications during clinical follow-up. Conclusions Endovascular stent-graft repair of traumatic pseudoaneurysm of carotid artery is safe and effective in the treatment of ruptured hemorrhage of the aneurysm of the carotid artery. It can recover the normal blood supply of the head and neck while sealing the carotid artery, and there are few complications. But still need a larger sample of clinical studies confirmed that further observation of long-term efficacy.