Mickley V, Kogel H, Vogel U
Aus der Abt. für Gefäss-, Thorax- und Herzchirurgie, Universität Ulm.
Vasa. 1992;21(4):415-21.
A 69-year-old woman presented with bilateral arm claudication caused by segmental occlusions of both brachial arteries. Bilateral retrograde ring-desobliteration resulted in restauration of full pulses. Microscopic examination of the resected specimen revealed giant cell arteritis. No other manifestations of the disease could be detected. At autopsy affection of the aortic arch and of the arm arteries is found in about 70% of patients with giant cell arterities. Symptoms occur in only about 5% of them. Arterial stenoses are successfully treated with corticosteroids. In case of chronic occlusion, however, ischemia-induced symptoms may necessitate an operation. Endarterectomy (i.e. total dissection of the destroyed inner arterial wall layers) should be preferred to bypass procedures. Subsequent long-term corticosteroid therapy should be instituted in order to treat the underlying disease, and to prevent reocclusions.
一名69岁女性因双侧肱动脉节段性闭塞出现双侧手臂间歇性跛行。双侧逆行环状血管再通术使脉搏完全恢复。对切除标本的显微镜检查显示为巨细胞动脉炎。未发现该疾病的其他表现。在巨细胞动脉炎患者中，约70%在尸检时发现主动脉弓和手臂动脉受累。其中只有约5%出现症状。动脉狭窄可通过皮质类固醇成功治疗。然而，对于慢性闭塞，缺血引起的症状可能需要进行手术。应首选内膜切除术（即完全剥离受损的动脉内壁层）而非旁路手术。应进行后续长期皮质类固醇治疗，以治疗潜在疾病并防止再闭塞。
