Department of Cardiothoracic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China.
Ann Thorac Surg. 2010 Apr;89(4):1289-91. doi: 10.1016/j.athoracsur.2009.08.068.
Aberrant right subclavian artery aneurysms are rare but carry a high risk of spontaneous rupture without any treatment. Aggressive early elective treatment is warranted. We present a hybrid endovascular treatment that was used to treat a 77-year-old woman with aberrant right subclavian artery aneurysm for whom surgical treatment would have been associated with high risk. A thoracic stent graft was used to cover the origin of aberrant right subclavian artery at the proximal descending aorta. To prevent any retrograde flow, an Amplatzer septal occluder was deployed at the distal subclavian artery. Axillo-axillary bypass with an 8-mm polytetrafluoroethylene graft was performed due to atherosclerosis change of the common carotid artery to restore the right arm perfusion and prevent vertebrobasilar insufficiency.
异常右锁骨下动脉动脉瘤罕见，但未经治疗有自发性破裂的高风险。需要积极的早期选择性治疗。我们介绍了一种混合血管内治疗方法，用于治疗一名 77 岁女性的异常右锁骨下动脉动脉瘤，手术治疗风险较高。一个胸主动脉支架移植物被用于覆盖近端降主动脉处异常右锁骨下动脉的起源。为了防止任何逆行血流，在远端锁骨下动脉处放置了一个 Amplatzer 房间隔封堵器。由于颈总动脉粥样硬化改变，进行了腋-腋旁路手术，使用 8 毫米聚四氟乙烯移植物，以恢复右臂灌注并预防椎基底动脉不足。
