Pseudo-aneurysm Associated with Endovascular Re-canalization for Internal Carotid Artery Occlusion

內頸動脈閉塞是相對罕見、但重要之導致暫時性腦缺氧跟中風的因素。外科的繞道手術雖是理論上的解決方法，但大規模的研究卻發現預後並沒有顯著的改善。最近臨床研究顯示可以用經皮血管腔內技術美開通完全閉塞的內頸動脈。在這份病例報告中，描述一個77歲的男性，接受經皮血管腔內技術開通完全閉塞的右內頸動脈並置放支架四個月後，臨床症狀再度出現。斷層掃瞄顯示右大腦缺氧的情形仍然存在，而血管攝影香現在之前支架的遠端出現了偽動脈瘤，壓迫內頭動脈造成管腔狹窄。這是從前的臨床報告從來沒有發現過的。我們在內頸動脈內置放支架，跨過偽動脈瘤的開口，流入偽動脈瘤動脈之血流明顯減少，且內頸動脈之管腔及血流亦恢復正常。這份病例報告描述了之前從未報導過的併發症，及其治療處置方式。今後在開通完全閉塞的內頸動脈時，也要考慮遠期偽動脈瘤出現的可能性。

關鍵字

內頸動脈閉塞；再開通；偽動脈瘤

並列摘要

Internal carotid artery occlusion (ICAO) is a relative uncommon but important cause of transient ischemic attack (TIA) and cerebral infarction. The feasibility of endovascular re-canalization has been reported in a recent article. In the present report, we describe a 77-year-old man who received endovascular re-canalization of right ICAO. His clinical symptoms recurred 4 months after the procedure, and follow-up perfusion computed tomography (CT) revealed right hemisphere ischemia. Repeat carotid angiogram showed a large pseudo-aneurysm with narrowed true lumen in the distal cervical carotid artery, most likely resulted from previous re-canalization procedure. A coronary stent was deployed to re-establish patency of the vessel, covering and jailing the orifice of the pseudo-aneurysm. Late pseudo-aneurysm formation should be considered as a potential complication after endovascular re-canalization of ICAO.

並列關鍵字

Internal carotid artery occlusion ； Re-canalization ； Pseudoaneurysm

國際替代計量

Pseudo-aneurysm Associated with Endovascular Re-canalization for Internal Carotid Artery Occlusion

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