目的:评估动脉覆膜支架在复杂颈动脉体瘤（carotid body tumor,CBT）切除术中的应用及术后不良事件。方法:本研究包括我科2018—2020年期间术中联合应用动脉覆膜支架重建（4例）和预重建颈内动脉（8例）的12例CBT病人,Shamblin Ⅱ型3例,Ⅲ型9例。统计和分析临床一般资料、术中情况、术后不良事件发生等。结果:12例手术成功率100%,均完整切除瘤体。平均手术时间（160±55） min,颈内动脉重建术中平均阻断时间（25±6） min。颈内动脉预重建术中无需阻断。术中平均出血量（342±101） mL。术后1年随访结果,暂时性神经损伤2例,术后覆膜支架阻塞1例,未发生永久性神经损伤及短暂性脑缺血发作。结论:Shamblin Ⅱ/Ⅲ型CBT术中应用覆膜支架重建或预重建颈内动脉可减少血管损伤,降低颈动脉阻断时间,减少相关不良事件发生。该治疗方法有待大样本的临床对照研究。

Objective To evaluate arterial covered stent used in the resection of complex carotid body tumor (CBT) and postoperative adverse events. Methods Twelve patients with CBT Shamblin type Ⅱ 3 cases and type Ⅲ 9 cases from 2018 to 2020 who underwent intraoperative combined arterial covered stent reconstruction (4 cases) or prereconstruction of internal carotid artery (8 cases) were included in this study. Statistics and analysis were done for general clinical data, intraoperative evaluation and postoperative adverse events. Results The operation was successful for all 12 cases. Average operative time was (160±55) min and blocking time was (25±6) min during carotid artery reconstruction. There was without need to block during internal carotid artery prereconstruction. Intraoperative bleeding was (342±101) mL. It was shown by follow-up one year later that there were 2 cases of temporary nerve injury and 1 case of postoperative covered stent obstruction. Both permanent nerve injury and transient ischemic attack were not found. Conclusions Stent graft used to reconstruct during operation or prereconstruction of internal carotid artery in CBT Shamblin type Ⅱ and type Ⅲ could reduce vascular injury, shorten blocking time of carotid artery, and lower adverse events. However, the treatment remained to be studied with large-sample controlled trial.