Dienemann H, Lauterjung K L, Liewald F, Frankl A, Kirchdorfer B
Chirurgische Klinik und Poliklinik der Universität, Klinikum Grosshadern, München.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:517-20.
Aneurysmectomy was performed in 37 patients with a traumatic aneurysm the aorta in segment III. 34 "cross-clamping" without bypass was used, 6 after preliminary transposition of the subclavian artery. 3 patients died after surgery, two of whom were more than 70 years old. 2 patients developed a paraparesis, which has in the meantime considerably improved. Hesitation to operate is justified only in older asymtomatic patients at high cardiac risk. Cross-clamping is preferable to more elaborate procedures. Preliminary transposition of the subclavian artery simplifies the proximal anastomosis and may contribute to spinal-cord protection.
对37例第三段主动脉创伤性动脉瘤患者实施了动脉瘤切除术。34例采用了无旁路“交叉钳夹”法,6例在锁骨下动脉初步转位后进行。3例患者术后死亡,其中2例年龄超过70岁。2例患者出现轻截瘫,目前已大为改善。仅对于心脏风险高的老年无症状患者,手术迟疑才是合理的。交叉钳夹比更复杂的手术方法更可取。锁骨下动脉初步转位简化了近端吻合,可能有助于脊髓保护。