Valdés Diego Caicedo, Karkos Christos D, Moy Petersen Juan Carlos, Fernández Julia Requena, González Rodrigo Fernández
Angiology and Vascular Surgery Department, Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
Vascular Surgery Unit, 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ann Vasc Surg. 2019 Feb;55:307.e13-307.e17. doi: 10.1016/j.avsg.2018.06.033. Epub 2018 Sep 12.
A pseudoaneurysm located at the subclavian artery ostium is an infrequent but life-threatening pathology that usually requires major thoracic surgery with a high risk of mortality and morbidity. Endovascular therapy applied to the aortic arch branches is a recent alternative technique, which is still in its early stages because dedicated endovascular devices for the aortic arch are lacking. In this article, we present the emergency endovascular management of a symptomatic pseudoaneurysm of the left subclavian artery ostium which was presumably secondary to an atherosclerotic plaque rupture. Endovascular exclusion required a combination of an abdominal aortic stent-graft extension cuff, which was placed via a retroperitoneal iliac access, and a subclavian artery periscope stent graft.
位于锁骨下动脉开口处的假性动脉瘤是一种罕见但危及生命的病变，通常需要进行高风险的开胸大手术，死亡率和发病率都很高。应用于主动脉弓分支的血管内治疗是一种较新的替代技术，由于缺乏专门用于主动脉弓的血管内装置，该技术仍处于早期阶段。在本文中，我们介绍了一名有症状的左锁骨下动脉开口处假性动脉瘤的急诊血管内治疗，该假性动脉瘤可能继发于动脉粥样硬化斑块破裂。血管内封堵需要联合使用经腹膜后髂动脉入路置入的腹主动脉覆膜支架延长袖套和锁骨下动脉潜望镜覆膜支架。
