Rispoli P, Varetto G, Conforti M, Tallia C, Rossato D, Gandini G
Postgraduate School of Vascular Surgery, University of Turin, Turin, Italy.
J Cardiovasc Surg (Torino). 2011 Oct;52(5):735-7. Epub 2008 Oct 24.
A 62-year-old man was incidentally diagnosed with a completely asymptomatic aberrant right subclavian artery (ARSA) aneurysm with a maximum diameter of 4.5 cm. This condition presents a postrupture mortality rate of 50% and the morbidity-mortality rates reported in the literature with traditional open repair procedures are of 25%. In our patient we planned a hybrid procedure and excluded the aneurysm by performing, first, a right carotid-subclavian bypass with ligation of the subclavian artery upstream from the vertebral artery and the internal mammary artery and, the day after, by covering its origin from the aortic arch with the placement of a thoracic endoprosthesis. A third session was necessary, three days later, because of a leak; a complete resolution of the condition was achieved by embolizing the still perfused residual aneurysmal sac with Balt metallic coils.
一名62岁男性偶然被诊断出患有完全无症状的右锁骨下动脉异常（ARSA）动脉瘤，最大直径为4.5厘米。这种情况破裂后的死亡率为50%，文献报道的传统开放修复手术的发病率和死亡率为25%。在我们的患者中，我们计划采用杂交手术，首先通过进行右颈动脉-锁骨下动脉搭桥术，结扎椎动脉和胸廓内动脉上游的锁骨下动脉，然后在第二天通过放置胸段血管内支架覆盖其从主动脉弓发出的部位，从而排除动脉瘤。三天后，由于渗漏，需要进行第三次手术；通过用Balt金属线圈栓塞仍有灌注的残余动脉瘤囊，病情得到了完全缓解。
