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두개강 및 경부의 외상성 혈관 손상: 혈관내 치료의 유용성
최은완 ( Eun Wan Choi ),문태일 ( Tae Il Moon ),이정한 ( Jeong Han Lee ),추용식 ( Yong Sik Chu ),배진건 ( Jin Kun Bae ),김옥준 ( Ok Jun Kim ),최성욱 ( Seong Wook Choi ),안정용 ( Jung Yong Ahn ),윤평호 ( Pyeong Ho Yoon ),김상흠 ( Sa 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Background: The diagnosis and management of traumatic craniocervical vessel injuries in emergency department continue to be controversial. Direct surgical repair with parent artery preservation may be still difficult. The purpose of this report is to determine the safety and efficacy of endovascular therapy in the management of craniocervical vascular injuries. Methods: Fifteen patients with traumatic carotid and vertebral lesions were treated using therapeutic endovascular methods. Endovascular therapy was accomplished by implanting the balloons, porous or polytetrafluoroethylene (PTFE)-covered stent, and/or embolic materials including coils or glue. Results: All fistulas and pseudoaneurysms were successfully embolized with coils, glue, or stents. The parent arteries of all patients except two patients were preserved. The reasons of the parent artery sacrifice are that thrombus formation due to coil migration into the parent artery and the existing transection of the parent artery, respectively. No additional surgical procedures for vascular lesions were required. There were no delayed neurological or vascular complications and no lesions recurred during follow-up periods (mean 26.9 months). Conclusion: The goal of endovascular therapy is the selective elimination of the vascular pathology with the normal patency of the cerebral arteries. The author`s experience demonstrates that endovascular therapy using stents, balloons, and coils is both feasible and safe in treatment of the traumatic vascular injuries. Long-term follow-up review of these repairs will be necessary to provide a full evaluation of the safety and efficacy of these devices.
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