脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
症  例
頚部動脈瘤に対して血管内治療を行った4例
蔵本 要二坂井 信幸今村 博敏小柳 正臣坂井 千秋国枝 武治上野 泰足立 秀光菊池 晴彦
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2011 年 39 巻 1 号 p. 48-53

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Cervical carotid artery aneurysms are rare and sometimes induce not only hemorrhage but also ischemic stroke. Various surgical treatments are reported to prevent hemorrhage and stroke. We report the result of endovascular therapies for 4 patients who had large or giant cervical carotid artery aneurysms.
Endovascular therapies were performed for 4 patients and 5 aneurysms, from January 2003 to October 2007. One patient had external carotid artery aneurysm and the other 3 patients had common or internal carotid artery aneurysms. One patient had 2 cervical carotid artery aneurysms.
Case 1 had an external carotid artery aneurysm and underwent parent artery occlusion (PAO); the aneurysm was occluded without any event. Case 2 had an internal carotid artery (ICA) aneurysm and also underwent PAO, but the internal carotid artery showed recanalization 2 days later on magnetic resonance image. Therefore, we added endovascular coil embolization and occluded the aneurysm completely. Case 3 had 1 aneurysm and Case 4 had 2 aneurysms on the common carotid artery (CCA) to ICA. Bare metal stents were deployed, followed by endovascular embolization for 2 aneurysms. One aneurysm in Case 4 on which only stenting was performed completely occluded 1 year after procedure. On 2 aneurysms combined stenting and coil embolization were performed. One was completely occluded, and the other had a tiny flow into the aneurysm, only confirmd by cervical ultrasound examination. No procedural complication or neurological symptoms and signs were recognized during these endovascular procedure.
Endovascular therapy was effective and safe for the cervical carotid artery areurysms. However, the aneurysm sometimes became recanalized, and it is important to treat the recurrent aneurysm.
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© 2011 一般社団法人 日本脳卒中の外科学会
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