Department of Internal Medicine, Pennsylvania Hospital of the University of Pennsylvania, Philadelphia.
Department of Internal Medicine, Pennsylvania Hospital of the University of Pennsylvania, Philadelphia.
Am J Med. 2017 Apr;130(4):409-416. doi: 10.1016/j.amjmed.2016.12.027. Epub 2017 Jan 19.
The diagnosis of brachiocephalic disease is often overlooked. Symptoms include arm claudication and vertebrobasilar insufficiency. In patients who have had the use of the internal mammary artery for coronary bypass surgery, the development of symptoms of myocardial ischemia should alert the clinician to the possibility of subclavian artery stenosis. Also, in patients who have had axillofemoral bypass, lower-extremity claudication may occur. Recognition involves physical examination and accurate noninvasive testing. Endovascular therapy has proven to be effective in alleviating symptoms in properly selected patients.
头臂血管疾病的诊断常常被忽视。其症状包括手臂跛行和椎基底动脉供血不足。在因冠状动脉旁路移植术而使用过内乳动脉的患者中，出现心肌缺血症状应提醒临床医生注意锁骨下动脉狭窄的可能性。同样，在腋股旁路术的患者中，可能会出现下肢跛行。识别包括体格检查和准确的无创检查。血管内治疗已被证明在适当选择的患者中可有效缓解症状。
