Endovascular interventional treatment of carotid artery injury / 中华创伤杂志

ABSTRACT

Objective To evaluate the efficacy and safety of the endovascular interventional minimally invasive techniques(IMIT)for treatment of carotid artery iniury. Methods A total of 111 cases of carotid artery injury diagnosed by digital subtraction angiography(DSA)were treated with IMIT.Except for 1 case of extracranial segment injury of internal carotid artery treated with transcatheter stentgraft placement to obturate the rupture of carotid artery,the other 110 cases of intracranial segment injury of internal carotid artery(ICA)were treated with embolization with balloons in 73,embolization with coils in 12,injection of NBCA and PVA in 6,stent-graft placement in 11 and embolization with multiple materials in 8. Results Angiography demonstrated rupture of extracranial segment of internal carotid artery and arteriovenous fistula(AVF)at the neck in 1 case,traumatic carotid cavernous fistula(TCCF)in 83.traumatic pseudoaneurysm at intracranial segment of carotid artery in 14 and both TCCF and pseudoaneurysm in 13.The interventional treatment succeeded in all cases and interual carotid arteries were well protected in 62 cases.Completion angiography documented complete obliteration of the fistulas,with complete disappearance of the clinical symptoms in 110 cases and improvement in 1.Minor complications occurred in 2 cases,without death occurred.During the follow-up for 1-14 months,16 cases reexamined with DSA,which showed that the symptoms of 3 cases reoccurred,2 of whom were cured by re-embolization and 1 was under clinical observation. Conclusions IMIT including transcatheter selective embolization and stent-graft implantation is minimally invasive,safe and effective for treatment of carotid artery injury.