Khatrí V P, Amin A K, Fisher J B
Department of Surgery, Easton Hospital, Pennsylvania 18042.
Ann Vasc Surg. 1992 Nov;6(6):530-2. doi: 10.1007/BF02000825.
Atherosclerotic occlusive disease of the upper extremity can be a challenging and complex problem for the vascular surgeon. Due to the variety of pathologies that can affect the upper extremity, an accurate diagnosis may be difficult to obtain. We describe the case of a 52-year-old white man who presents with a pulsatile mass on the volar aspect of the right wrist. Arteriography of the aortic arch and right upper extremity revealed an 80% atherosclerotic stenosis at the origin of the right subclavian artery, as well as occlusion of the superficial radial artery. The occlusion resulted in the formation of an aneurysmal collateral, which communicated with the superficial palmar arch. A right carotid-subclavian bypass was necessary to prevent further embolic phenomena. The radial artery aneurysm was treated by resection and primary repair.
上肢动脉粥样硬化闭塞性疾病对于血管外科医生而言可能是一个具有挑战性且复杂的问题。由于多种病理情况均可影响上肢,准确诊断可能难以实现。我们描述了一名52岁白人男性的病例,其右腕掌侧出现搏动性肿块。主动脉弓和右上肢动脉造影显示右锁骨下动脉起始处存在80%的动脉粥样硬化性狭窄,同时桡动脉浅支闭塞。该闭塞导致形成一个与掌浅弓相通的动脉瘤样侧支循环。为防止进一步的栓塞现象,需要进行右颈动脉 - 锁骨下动脉搭桥术。桡动脉动脉瘤通过切除和一期修复进行治疗。