Endovascular management of carotid blowout syndrome.

IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY
Neurological Research Pub Date : 2025-02-01 Epub Date: 2025-01-26 DOI:10.1080/01616412.2024.2448635
Omer F Nas, Sedat G Kandemirli, Baris Korkmaz, Mehmet F Inecikli, Muhammed F Oztepe, Cem Bilgin, Bahattin Hakyemez
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引用次数: 0

Abstract

Objectives: To evaluate success, complications and efficacy for endovascular management for carotid blowout syndrome.

Methods: Images were evaluated for contrast extravasation, vessel wall irregularity, pseudoaneurysm/aneurysm formation. Hemostatic results in the immediate postprocedural period and procedure related infarcts were assessed.

Results: Total of 20 lesions in 21 patients were detected on digital subtraction angiography (DSA). In a case of esthesioneuroblastoma with active bleeding, DSA failed to show vascular abnormality. There was active contrast extravasation in 7 cases. Treatment modalities included covered stent placement (n = 3), pseudoaneurysm/aneurysm embolization (n = 4), parent artery occlusion (n = 13) and PVA injection (n = 1) in the immediate postoperative period was achieved in all except one case. During the post-procedural period, 6 patients (28.6%) suffered from cerebral ischemia. Rebleeding episodes were encountered in 10 cases (47.6%) after a mean duration of 35 days which responded to tamponade in 4 cases. Diagnostic DSA was performed in 5 of the cases, which failed to identify bleeding source in 2 and remaining 3 cases were treated by endovascular means. A case with massive hemorrhage 1-hour after endovascular treatment died before any intervention could be performed.

Conclusion: Endovascular treatment can achieve immediate hemostasis to prevent otherwise a highly morbid and mortal complication. However, rebleeding rates are high and cerebral ischemia with or without neurologic deficit occur in a non-negligible percentage of patients.

颈动脉爆裂综合征的血管内治疗。
目的:评价颈动脉爆裂综合征血管内治疗的成功率、并发症及疗效。方法:影像学检查造影剂外渗、血管壁不规则、假性动脉瘤/动脉瘤形成。评估手术后立即止血效果和手术相关梗死。结果:21例患者经数字减影血管造影(DSA)共检出20个病变。在一例伴有活动性出血的神经母细胞瘤中,DSA未显示血管异常。7例有活动性造影剂外渗。除1例外,其余均在术后立即完成了覆盖支架置入(n = 3)、假性动脉瘤/动脉瘤栓塞(n = 4)、母动脉闭塞(n = 13)和PVA注射(n = 1)。术后发生脑缺血6例(28.6%)。平均35天后再出血10例(47.6%),其中4例对填塞有反应。5例行诊断性DSA, 2例出血源不明,其余3例行血管内治疗。1例在血管内治疗1小时后大出血,在任何干预前死亡。结论:血管内治疗可立即止血,避免并发症的发生。然而,再出血率很高,脑缺血伴或不伴神经功能缺损的患者比例不可忽视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurological Research
Neurological Research 医学-临床神经学
CiteScore
3.60
自引率
0.00%
发文量
116
审稿时长
5.3 months
期刊介绍: Neurological Research is an international, peer-reviewed journal for reporting both basic and clinical research in the fields of neurosurgery, neurology, neuroengineering and neurosciences. It provides a medium for those who recognize the wider implications of their work and who wish to be informed of the relevant experience of others in related and more distant fields. The scope of the journal includes: •Stem cell applications •Molecular neuroscience •Neuropharmacology •Neuroradiology •Neurochemistry •Biomathematical models •Endovascular neurosurgery •Innovation in neurosurgery.
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