Rosa Patricio, Gillespie David L, Goff James M, O'donnell Sean D, Starnes Benjamin
Tripler Army Medical Center and Walter Reed Medical Center, HI 95859, USA.
J Vasc Surg. 2003 Jun;37(6):1318-21. doi: 10.1016/s0741-5214(02)75464-5.
A young, otherwise healthy man had chronic cough of 16 months' duration. Evaluation revealed an aberrant right subclavian artery. Kommerell's diverticulum without aneurysmal degeneration was present. Imaging studies showed compression of the esophagus but not the trachea. Results of methacholine challenge test were negative for evidence of reactive airway disease, but suggested mild variable intrathoracic obstruction. While aberrant right subclavian artery syndrome most commonly involves dysphagia, our patient's only symptom was cough. Right subclavian artery to right common carotid artery transposition was performed, with oversewing of the subclavian artery stump to the left of the esophagus through a right supraclavicular incision. This treatment was curative, with complete resolution of symptoms.
一名年轻且其他方面健康的男性有持续16个月的慢性咳嗽。评估发现右锁骨下动脉异常。存在Kommerell憩室但无动脉瘤样退变。影像学检查显示食管受压但气管未受压。乙酰甲胆碱激发试验结果阴性，无反应性气道疾病证据，但提示轻度可变的胸内梗阻。虽然异常右锁骨下动脉综合征最常见的表现是吞咽困难，但我们的患者唯一的症状是咳嗽。通过右锁骨上切口进行了右锁骨下动脉至右颈总动脉转位，并将锁骨下动脉残端缝扎在食管左侧。这种治疗是治愈性的，症状完全缓解。
