一例因高安动脉炎导致无名动脉和右颈总动脉瘤的复杂病例。

A complicated case of innominate and right common arterial aneurysms due to Takayasu's arteritis.

作者信息

Wang Wen-Da, Sun Rui, Zhou Meng-Xin, Liu Xing-Rong, Zheng Yue-Hong, Chen Yue-Xin

机构信息

Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

World J Clin Cases. 2019 Jul 6;7(13):1671-1676. doi: 10.12998/wjcc.v7.i13.1671.

DOI:10.12998/wjcc.v7.i13.1671

PMID:31367626

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6658365/

Abstract

BACKGROUND

Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases.

CASE SUMMARY

We report a 35-year-old female who suffered from Takayasu's arteritis. The patient did not get regular treatment, and IAA and right common carotid artery aneurysm developed, which complicated with occlusion of the left carotid artery, subclavian artery, and the initial part of the left vertebral artery. The patient also had moderate aortic valve insufficiency. With inflammation being controlled well, the patient received the surgery for arterial aneurysms of innominate and right common carotid arteries and aortic valve insufficiency. The shunts for cerebral blood supply were designed to protect the brain and the surgery was conducted successfully under extracorporeal circulation.

CONCLUSION

The case illustrates that open surgery may be appropriate for some complicated IAAs, and brain protection is important.

摘要

背景

无名动脉动脉瘤（IAA）相对罕见。在一些IAA病例中，血管内治疗已成为开放手术的替代方法，但在复杂病例中仍需要开放修复。

病例摘要

我们报告一名35岁患有Takayasu动脉炎的女性。该患者未接受正规治疗，出现了IAA和右颈总动脉瘤，并伴有左颈动脉、锁骨下动脉及左椎动脉起始部闭塞。患者还存在中度主动脉瓣关闭不全。在炎症得到良好控制后，患者接受了无名动脉和右颈总动脉瘤以及主动脉瓣关闭不全的手术。设计了脑供血分流以保护大脑，并在体外循环下成功进行了手术。