Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Fla, USA.
J Vasc Surg. 2011 Feb;53(2):528-30. doi: 10.1016/j.jvs.2010.07.050.
Surgical repair of proximal right subclavian artery aneurysms can be difficult. They typically require a combined mediastinal exposure to control the innominate and right common carotid arteries and a supra- or infraclavicular exposure for distal control, with either a segmental resection and bypass or a bifurcated reconstruction. In this report, we present four cases utilizing a single-stage, hybrid technique combining an endovascular stent graft and an extra-anatomical bypass to repair proximal right subclavian artery aneurysms without the need for mediastinal exposure or extensive surgical reconstruction. There were no deaths and two minor neurologic events.
手术修复近端右锁骨下动脉动脉瘤较为困难。此类手术通常需要联合纵隔显露以控制无名动脉和右颈总动脉,并采用锁骨上或锁骨下入路以实现远端控制,采用节段切除和旁路转流或分叉重建。本研究报告了 4 例采用一站式杂交技术修复近端右锁骨下动脉动脉瘤的病例,该技术结合了血管内支架移植物和解剖外旁路,无需进行纵隔显露或广泛的外科重建。手术无死亡病例,仅有 2 例出现轻微的神经系统并发症。