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[右侧主动脉弓伴左锁骨下动脉异常起源:病例报告]

[Right-sided aortic arch with anomalous origin of the left subclavian artery: case report].

作者信息

Vučurević Goran, Tanasković Slobodan, Ilijevski Nenad, Kovačević Vladimir, Kecmanović Vladimir, Radak Djordje

出版信息

Srp Arh Celok Lek. 2011 Sep-Oct;139(9-10):666-8. doi: 10.2298/sarh1110666v.

Abstract

INTRODUCTION

A right-sided aortic arch is a rare congenital defect of the aorta with incidence of 0.05% to 0.1% reported in published series. Usually it is associated with congenital heart anomalies and esophageal and tracheal compression symptoms. We present a case of a right-sided aortic arch of anomalous left subclavian artery origin, accidentally revealed during multislice CT (MSCT) supraaortic branches angiography.

CASE OUTLINE

A 53-year-old female patient was examined at the Outpatients' Unit of the Vascular Surgery University Clinic for vertigo, occasional dizziness and difficulty with swallowing. Physical examination revealed a murmur of the left supraclavicular space, with 15 mmHg lower rate of arterial tension on the left arm. Ultrasound of carotid arteries revealed 60% stenosis of the left subclavian artery and bilateral internal carotid artery elongation. MSCT angiography revealed a right-sided aortic arch with aberrant separation of the left subclavian artery that was narrowed 50%, while internal carotid arteries were marginally elongated. There was no need for surgical treatment or percutaneous interventions, so that conservative treatment was indicated.

CONCLUSION

A right-sided aortic arch is a very rare anomaly of the location and branching of the aorta. Multislice CT angiography is of great importance in the diagnostics of this rare disease.

摘要

引言

右位主动脉弓是一种罕见的主动脉先天性缺陷,在已发表的系列研究中报告的发病率为0.05%至0.1%。通常它与先天性心脏异常以及食管和气管压迫症状相关。我们报告一例起源异常的左锁骨下动脉的右位主动脉弓病例,该病例在多层CT(MSCT)主动脉弓上分支血管造影期间意外发现。

病例概述

一名53岁女性患者因眩晕、偶尔头晕和吞咽困难在血管外科大学诊所门诊接受检查。体格检查发现左锁骨上间隙有杂音,左臂动脉压降低15 mmHg。颈动脉超声显示左锁骨下动脉狭窄60%,双侧颈内动脉延长。MSCT血管造影显示右位主动脉弓,左锁骨下动脉异常分支且狭窄50%,而颈内动脉略有延长。无需手术治疗或经皮介入,因此采取保守治疗。

结论

右位主动脉弓是一种非常罕见的主动脉位置和分支异常。多层CT血管造影在这种罕见疾病的诊断中具有重要意义。

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