du Toit D F, Strauss D C, Blaszczyk M, de Villiers R, Warren B L
Department of Surgery, Tygerberg Hospital and the University of Stellenbosch, Tygerberg, South Africa.
Eur J Vasc Endovasc Surg. 2000 May;19(5):489-95. doi: 10.1053/ejvs.1999.1050.
to establish the feasibility of stent-graft treatment of penetrating thoracic outlet arterial injuries.
prospective study.
forty-one patients with penetrating injuries to the carotid, subclavian and proximal axillary arteries admitted between August 1998 and May 1999 were studied. Patients requiring urgent surgical exploration for active bleeding (n=26) were excluded. Remaining patients underwent arteriography to assess suitability for stent-graft placement. After successful stent-graft treatment clinical and sonographic follow-up were done at 1 month and thereafter 3-monthly.
of the 15 patients considered, 10 patients qualified for stent-graft treatment (seven male, three female, mean age 27 years). The vessels involved were subclavian artery (seven), carotid artery (two) and axillary artery (one). Seven had arteriovenous fistulae and three, pseudoaneurysms. Stent-graft treatment was successful in all 10 patients with no procedure-related complications. On mean follow-up of 7 months no complications were encountered.
endovascular treatment shows promise as a treatment modality for thoracic outlet arterial injuries. Long-term follow-up is required for comparison to the results of standard surgical repair.
确定覆膜支架治疗穿透性胸廓出口动脉损伤的可行性。
前瞻性研究。
对1998年8月至1999年5月收治的41例颈动脉、锁骨下动脉及腋动脉近端穿透伤患者进行研究。因活动性出血需要紧急手术探查的患者（n = 26）被排除。其余患者接受血管造影以评估是否适合放置覆膜支架。覆膜支架治疗成功后，在1个月时进行临床和超声随访，此后每3个月随访一次。
在15例被评估的患者中，10例符合覆膜支架治疗条件（7例男性，3例女性，平均年龄27岁）。受累血管为锁骨下动脉（7例）、颈动脉（2例）和腋动脉（1例）。7例有动静脉瘘，3例有假性动脉瘤。10例患者覆膜支架治疗均成功，无手术相关并发症。平均随访7个月，未出现并发症。
血管内治疗作为胸廓出口动脉损伤的一种治疗方式显示出前景。需要进行长期随访以与标准手术修复的结果进行比较。
