Traumatic injury of vertebral artery complicated by formation of a giant pseudoaneurysm of the V3 segment (clinical observation and literature review)

A. A. Ayrapetyan, D. G. Gromov, S. Papoyan, D. V. Smyalovskiy, K. S. Asaturyan, S. S. Starikov, A. Zaytsev, E. V. Tavlueva
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Abstract

Traumatic vertebral artery injury (TVAI) is a rare but severe pathology which can be associated both with penetrating injury of the neck and blunt or unclassified injury. Injury of the vertebral artery, especially due to gunshot or knife wounds, causes severe condition of the patients, development of a wide spectrum of complications including life-threatening, high rates of disabilities and mortality.There is no consensus on the treatment tactics for this pathology. Open surgery as the first stage of surgical intervention can be used in a limited number of cases. X-ray endovascular techniques of TVAI treatment are considered to be preferable.We present a clinical case of a 27‑year-old patient with TVAI caused by a penetrating gunshot wound of the neck and complicated by formation of a giant pseudoaneurysm of the V3 segment of the vertebral artery. Two-stage combination treatment of TVAI was performed using endovascular and open surgical techniques.Descriptions of TVAI cases are rare, and further accumulation and analysis of corresponding data and proposals on treatment of the patients with TVAI will help to formulate precise algorithms of doctors’ actions and optimize treatment tactics.
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椎动脉外伤并发 V3 段巨大假性动脉瘤形成(临床观察和文献综述)
创伤性椎动脉损伤(Traumatic vertebral artery injury,TVAI)是一种罕见但严重的病理现象,既可能与颈部穿透性损伤有关,也可能与钝伤或未分类的损伤有关。椎动脉损伤,尤其是枪伤或刀伤,会导致患者病情严重,出现多种并发症,包括危及生命、高致残率和高死亡率。开放手术作为外科干预的第一阶段,可用于少数病例。我们介绍了一例临床病例,患者 27 岁,因颈部穿透性枪伤导致 TVAI,并因椎动脉 V3 段形成巨大假性动脉瘤而并发症。关于 TVAI 病例的描述非常罕见,进一步积累和分析相应的数据以及关于 TVAI 患者治疗的建议将有助于制定医生行动的精确算法和优化治疗策略。
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