Barbee Jacob P, Stevens Scott L, Gaines Thomas E, Gash Judson R
University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA.
Vasc Endovascular Surg. 2007 Aug-Sep;41(4):355-7. doi: 10.1177/1538574407302847.
Cervical aortic arch (CAA) is a rare congenital anomaly of the aortic arch. Rarely, CAA is associated with aneurysm of the arch and great vessels. A 32-year-old male patient, previously in good health, presented with 2 weeks of severe chest pain. Radiographic evaluation revealed a CAA with aneurysmal dilation of the distal aortic arch. The aneurysm extended into the left subclavian artery. There was also marked angulation just distal to the aneurysmal portion. The aneurysmal arch and subclavian artery were repaired using a thoracic aortic endograft. An open axillary-to-axillary bypass was performed, and the left axillary artery was ligated proximally. This restored perfusion to the left upper extremity and effectively excluded the aneurysm sac. Immediately postoperatively, the patient's chest pain resolved, and he has remained symptom free. To the authors' knowledge, this is the first reported repair of a cervical arch aneurysm by endovascular technique.
颈主动脉弓（CAA）是一种罕见的主动脉弓先天性异常。CAA很少与主动脉弓及大血管的动脉瘤相关。一名32岁男性患者，既往身体健康，出现了2周的严重胸痛。影像学评估显示为CAA，伴有主动脉弓远端的动脉瘤样扩张。动脉瘤延伸至左锁骨下动脉。在动脉瘤部分的远侧也有明显的成角。采用胸主动脉腔内移植物修复了动脉瘤样弓和锁骨下动脉。进行了开放的腋-腋旁路手术，并在近端结扎了左腋动脉。这恢复了左上肢的灌注并有效地排除了动脉瘤囊。术后患者的胸痛立即缓解，且一直无症状。据作者所知，这是首次报道采用血管内技术修复颈弓动脉瘤。
