Ishihara H, Hamanaka Y, Sueda T, Ohno Y, Matsuura Y, Muraoka R, Chiba Y
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1988 Mar;89(3):437-42.
The authors, having experienced 17 cases of subclavian arterial obstruction at its origin in Montpellier, France and in Japan, performed direct anastomosis between the divided end of the proximal subclavian artery and the ipsilateral common carotid artery (transposition technique) in 12 cases. Our series of 17 patients ranging in age from 30 to 73 years who were evaluated for variety of symptoms: 8 had subclavian steal syndrome; 12 had claudication of upper extremity; 1 had visual disturbance; 3 had vertigo; and 1 had ear throbbing. Twelve patients were treated surgically with division of the proximal subclavian artery and its anastomosis to the common carotid artery by means of supraclavicular cervicotomy. One was treated with carotid subclavian bypass grafting, and 4 were placed aorto-carotid-subclavian bypass grafting with median sternotomy because of the proximal occlusive lesions at the origins of common carotid and subclavian artery due to aortitis syndrome. All the patients were relieved from the symptoms which had been existed in pre-operative stage. The transposition technique is simple, effective and few complications.
作者在法国蒙彼利埃和日本共经历了17例锁骨下动脉起始部阻塞病例，其中12例采用了将近端锁骨下动脉断端与同侧颈总动脉直接吻合的方法（转位技术）。我们的17例患者年龄在30至73岁之间，因各种症状接受评估：8例患有锁骨下动脉盗血综合征；12例有上肢间歇性跛行；1例有视觉障碍；3例有眩晕；1例有耳部搏动。12例患者通过锁骨上颈部切开术进行手术治疗，即切断近端锁骨下动脉并将其与颈总动脉吻合。1例接受了颈动脉-锁骨下动脉搭桥术，4例因大动脉炎综合征导致颈总动脉和锁骨下动脉起始部近端闭塞性病变，通过正中胸骨切开术进行了主动脉-颈动脉-锁骨下动脉搭桥术。所有患者术前存在的症状均得到缓解。转位技术简单、有效且并发症少。
