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[在勒里什综合征患者冠状动脉手术前对胸廓内动脉进行评估的重要性]

[The importance of investigating the internal thoracic artery before coronary artery surgery in Leriche's syndrome].

作者信息

Ferrer María C, Calvo Isabel, Sánchez-Rubio Juan, Galache Gabriel, Diarte José A, Lukic Antonela, Portolés Ana, Placer Luis

机构信息

Sección de Hemodinámica, Hospital Universitario Miguel Servet, Zaragoza, España.

出版信息

Rev Esp Cardiol. 2007 Nov;60(11):1198-201.

Abstract

Frequently, both peripheral and coronary artery disease are present in the same patient. In patients with abdominal aortic occlusion (i.e., Leriche's syndrome) or femoroiliac occlusion, collateral circulation to the lower extremities can originate in branches of the abdominal aorta or even in the internal thoracic artery (depending on the level of the occlusion). It is important to identify the origin of this circulation during diagnostic procedures, especially in patients who may need to undergo coronary revascularization surgery since, in cases where the majority of the collateral circulation originates in the internal thoracic artery, using the artery as a coronary graft could lead to acute ischemia of the lower extremities. We present three patients with Leriche's syndrome in whom the internal thoracic artery was the origin of the collateral circulation to the ipsilateral femoral artery.

摘要

外周动脉疾病和冠状动脉疾病常常同时存在于同一患者身上。在患有腹主动脉闭塞(即勒里什综合征)或股髂动脉闭塞的患者中,下肢的侧支循环可起源于腹主动脉的分支,甚至起源于胸廓内动脉(取决于闭塞的部位)。在诊断过程中确定这种循环的起源很重要,特别是对于可能需要接受冠状动脉血运重建手术的患者,因为在大多数侧支循环起源于胸廓内动脉的情况下,将该动脉用作冠状动脉移植物可能会导致下肢急性缺血。我们报告了三例勒里什综合征患者,其胸廓内动脉是同侧股动脉侧支循环的起源。

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