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迷走右锁骨下动脉(lusoria动脉):最重要变异之一的形态学和临床方面——对141篇报告的系统研究

The aberrant right subclavian artery (arteria lusoria): the morphological and clinical aspects of one of the most important variations--a systematic study of 141 reports.

作者信息

Polguj Michał, Chrzanowski Łukasz, Kasprzak Jarosław D, Stefańczyk Ludomir, Topol Mirosław, Majos Agata

机构信息

Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136 Łódź, Poland.

Department of Cardiology, Medical University of Łódź, Kniaziewicza 33, 90-153 Łódź, Poland.

出版信息

ScientificWorldJournal. 2014;2014:292734. doi: 10.1155/2014/292734. Epub 2014 Jul 1.

Abstract

The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was 49.9 ± 19.4 years for all patients but 54.0 ± 19.6 years and 44.9 ± 18.1 years for female and male subjects, respectively (P = 0.0061). The most common symptoms in this group were dysphagia (71.2%), dyspnea (18.7%), retrosternal pain (17.0%), cough (7.6%), and weight loss (5.9%). The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%), Kommerell's diverticulum (14.9%), aneurysm of the artery itself (12.8%), and a right sided aortic arch (9.2%). In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss.

摘要

可以说,主动脉弓最重要的异常情况是存在迷走右锁骨下动脉(又称先天性右锁骨下动脉异常)。如果该血管压迫相邻结构,可能会产生多种症状。本研究的目的是介绍迷走右锁骨下动脉的形态学和临床特征。通过严格预定的标准在三个不同的数据库中检索相关文献综述。在141例病例中,15例为尸体解剖病例,126例有临床记录。研究对象的性别分布为女性占55.3%,男性占44.7%。所有患者出现症状时的平均年龄为49.9±19.4岁,女性患者为54.0±19.6岁,男性患者为44.9±18.1岁(P = 0.0061)。该组中最常见的症状为吞咽困难(71.2%)、呼吸困难(18.7%)、胸骨后疼痛(17.0%)、咳嗽(7.6%)和体重减轻(5.9%)。与迷走右锁骨下动脉并存的血管异常包括双颈动脉干(19.2%)、Kommerell憩室(14.9%)、动脉本身的动脉瘤(12.8%)和右侧主动脉弓(9.2%)。总之,迷走右锁骨下动脉对相邻结构的压迫需要与其他表现为吞咽困难、呼吸困难、胸骨后疼痛、咳嗽和体重减轻的疾病相鉴别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a01e/4102086/de557db58807/TSWJ2014-292734.001.jpg

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