| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.12 MB | Adobe PDF |
Authors
Abstract(s)
Introdução: O acidente vascular cerebral isquémico é uma das principais causas de mortalidade e morbilidade na Europa e em todo o Mundo Ocidental. As causas raras de acidente vascular cerebral são responsáveis por menos de 1% dos casos e incluem, entre outras, a patologia degenerativa dos troncos supra-aórticos como os aneurismas da carótida extracraniana.
Materiais e métodos: Foi realizada uma pesquisa bibliográfica através do motor de busca da PubMed com os termos “extracranial carotid artery aneurysm” e “extracranial carotid aneurysm” e selecionados todos os artigos referentes aos últimos 15 anos, escritos em língua inglesa e referentes ao aneurisma de etiologia degenerativa. Foram excluídas patologias específicas e aneurismas pediátricos. Sempre que uma referência bibliográfica foi considerada relevante, procedeu-se à sua consulta. A pesquisa foi complementada com a consulta de documentos de outras entidades científicas. Foi ainda, incluída a casuística de Serviço da Angiologia e Cirurgia Vascular do Centro Hospitalar Tondela Viseu.
Resultados: A análise da literatura sugere que a etiologia degenerativa para o aneurisma da carótida extracraniana predomina, que a apresentação com evento secundário a lesão do sistema nervoso central é a mais frequente e que o tratamento de eleição é a resseção aneurismática seguida de revascularização. A série de aneurismas do Centro Hospitalar Tondela Viseu conta com 3 doentes tratados a 5 aneurismas e as características desta série são coincidentes com o que está descrito na literatura.
Conclusões: A evidência atual sugere que o tratamento invasivo do aneurisma da carótida extracraniana pode prevenir a ocorrência de acidentes vasculares cerebrais isquémicos e ainda que, nas últimas décadas, houve uma evolução nas opções terapêuticas que passaram a incluir a abordagem endovascular. O número reduzido de casos nas séries descritas desta patologia, faz com que haja ainda desconhecimento sobre história natural da doença e falta de um consenso sobre a melhor abordagem diagnóstica e terapêutica.
Introduction: Ischemic stroke is one of the main causes of mortality and morbidity in Europe and in all occidental world. Rare causes of ischemic stroke count for less than 1% of cases and include some degenerative pathologies of supra-aortic trunks namely, extracranial carotid aneurysms. Materials and methods: Pubmed research with the terms “extracranial carotid artery aneurysm” and “extracranial carotid aneurysm” in the last 15 years, written in English and concerning aneurysm’s degenerative etiology. Were excluded specific pathologies and pediatric aneurysms. Whenever a bibliographic reference was considered relevant, it was proceeded to its consult. Documents from other scientific entities complemented the research. It was included a case series treated in the Department of Angiology and Vascular Surgery of Centro Hospitalar Tondela Viseu. Results: Literature analysis suggests that the main etiology for extracranial carotid aneurysms is degenerative, that presentation with a lesion of central nervous system is the most frequent and that the preferred treatment is aneurysmatic resection with revascularization. The local case series includes 3 patients treated to 5 aneurysms and this case series’ characteristics are close to those described in literature. Conclusion: Actual evidence suggests that invasive treatment of extracranial carotid aneurysm may prevent ischemic stroke and that in the last decades, there was an evolution in therapeutic options with the inclusion of endovascular approach. The short number of cases described, contributes for the lack of knowledge about natural history of this pathology and no consensus regarding best diagnostic approach and therapeutic.
Introduction: Ischemic stroke is one of the main causes of mortality and morbidity in Europe and in all occidental world. Rare causes of ischemic stroke count for less than 1% of cases and include some degenerative pathologies of supra-aortic trunks namely, extracranial carotid aneurysms. Materials and methods: Pubmed research with the terms “extracranial carotid artery aneurysm” and “extracranial carotid aneurysm” in the last 15 years, written in English and concerning aneurysm’s degenerative etiology. Were excluded specific pathologies and pediatric aneurysms. Whenever a bibliographic reference was considered relevant, it was proceeded to its consult. Documents from other scientific entities complemented the research. It was included a case series treated in the Department of Angiology and Vascular Surgery of Centro Hospitalar Tondela Viseu. Results: Literature analysis suggests that the main etiology for extracranial carotid aneurysms is degenerative, that presentation with a lesion of central nervous system is the most frequent and that the preferred treatment is aneurysmatic resection with revascularization. The local case series includes 3 patients treated to 5 aneurysms and this case series’ characteristics are close to those described in literature. Conclusion: Actual evidence suggests that invasive treatment of extracranial carotid aneurysm may prevent ischemic stroke and that in the last decades, there was an evolution in therapeutic options with the inclusion of endovascular approach. The short number of cases described, contributes for the lack of knowledge about natural history of this pathology and no consensus regarding best diagnostic approach and therapeutic.
Description
Keywords
Acidente Vascular Cerebral Isquémico Aneurisma Carotídeo