Lindblom Rickard P F, Zemgulis Vitas, Lilieqvist Andreas, Nyman Rickard
Department of Cardiothoracic Surgery and Anesthesia, Uppsala University Hospital, Uppsala, Sweden.
Interact Cardiovasc Thorac Surg. 2013 Sep;17(3):583-5. doi: 10.1093/icvts/ivt248. Epub 2013 Jun 4.
Internal thoracic artery (ITA) aneurysms are rare, but a rupture is potentially fatal. Most cases of ITA aneurysms are iatrogenic, caused by, for instance, previous sternotomy or pacemaker implantation. Other known aetiologies are vasculopathies, either of inflammatory origin or as part of connective tissue disorders like Marfan's syndrome, Ehler-Dahnlos syndrome or neurofibromatosis Type 1. Idiopathic ITA aneurysms are exceedingly scarce. The present case illustrates an unusual scenario, which posed diagnostic challenges, where spontaneous rupture of an idiopathic or possibly very late post-traumatic aneurysm of the left ITA led to a life-threatening bleeding, successfully treated by endovascular coiling with standby preparation for conversion to open surgery. This case demonstrates the importance of the careful interpretation of radiological findings and the significance of multidisciplinary collaboration between radiologist and clinician.
胸廓内动脉（ITA）动脉瘤较为罕见，但破裂可能致命。大多数ITA动脉瘤病例是医源性的，例如由先前的胸骨切开术或起搏器植入引起。其他已知病因是血管病变，其起源于炎症或作为结缔组织疾病的一部分，如马凡综合征、埃勒斯-丹洛斯综合征或1型神经纤维瘤病。特发性ITA动脉瘤极为罕见。本病例说明了一种不寻常的情况，这种情况带来了诊断挑战，即左ITA特发性或可能是非常晚期创伤后动脉瘤的自发破裂导致危及生命的出血，通过血管内栓塞成功治疗，并做好了转为开放手术的备用准备。该病例证明了仔细解读影像学结果的重要性以及放射科医生和临床医生之间多学科协作的意义。
