ステント留置後も増大しコイル塞栓術にて治癒し得た頸動脈偽性動脈瘤の1例

Combination of Stenting and Coil Embolization for Carotid Artery Pseudoaneurysm Causing Symptomatic Mass Effect:Case Report

Ⅰ．はじめに

　頸動脈偽性動脈瘤は，頸部打撲や穿通創などの外傷や脳血管撮影など医源性のものが原因として多く，特発性頸動脈解離に合併することもある．虚血症状を呈するものは内科的加療が奏功することもあるが，圧迫症状を有するものは困難な外科的治療を必要とする．今回，われわれはステント留置後も増大したため，柄部をコイルで閉塞することにより治癒し得た頸動脈偽性動脈瘤の1症例を経験したので，若干の文献的考察を加え報告する．

A case of cervical pseudoaneurysm secondary to carotid artery dissection causing symptomatic mass effect was re-ported. A 60-year-old woman presented with the complaint of right neck swelling and dysphagia that was considered to be the mass effect of a pseudoaneurysm caused by dissection of the right common carotid artery (CCA). Although a self-expanding stent was deployed to cover the orifice of the pseudoaneurysm, the pseudoaneurysm had been en-larged because of thrombus formation on the inner wall. A microcatheter was guided through the stent mesh into the aneurysm, and Guglielmi detachable coils were placed to embolize the orifice.