Takahashi Yosuke, Sasaki Yasuyuki, Kato Yasuyuki, Motoki Manabu, Bito Yasuyuki, Morisaki Akimasa, Miyabe Makoto, Inno Gouki
Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
Ann Thorac Surg. 2015 Sep;100(3):1089-91. doi: 10.1016/j.athoracsur.2014.10.081.
We report a patient with an arch aneurysm with an aberrant right subclavian artery who underwent successful endovascular treatment with the chimney technique and bilateral carotid artery-to-subclavian artery bypasses. We used a chimney graft in the left carotid artery to preserve its flow. The bilateral carotid-to-subclavian artery bypasses preserved perfusion of the bilateral vertebral arteries. A thoracic stent graft was subsequently deployed in the aortic arch over the chimney graft of the left carotid artery. There have been few reports about less-invasive treatment for arch aneurysm with aberrant right subclavian artery. This technique was an effective strategy to avoid a high-risk open operation.
我们报告了一例患有主动脉弓动脉瘤且右锁骨下动脉异常的患者，该患者接受了烟囱技术和双侧颈动脉 - 锁骨下动脉旁路移植术的成功血管内治疗。我们在左颈动脉使用烟囱式移植物以维持其血流。双侧颈动脉 - 锁骨下动脉旁路移植术保留了双侧椎动脉的灌注。随后在左颈动脉烟囱式移植物上方的主动脉弓中植入了胸段覆膜支架。关于右锁骨下动脉异常的主动脉弓动脉瘤的微创治疗报道较少。该技术是避免高风险开放手术的有效策略。
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