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锁骨切除术用于暴露并再次修复扩张性复发性右锁骨下动脉瘤。

Claviculectomy for exposure and redo repair of expanding, recurrent right subclavian aneurysm.

作者信息

Bellomo Tiffany R, Robinson Scott T, Lynch William R, Kim Karen M, Corriere Matthew A

机构信息

Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, Mich.

Deparmtent of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, Mich.

出版信息

J Vasc Surg Cases Innov Tech. 2021 Sep 29;7(4):694-697. doi: 10.1016/j.jvscit.2021.08.014. eCollection 2021 Dec.

Abstract

Subclavian artery aneurysms (SAAs) are rare, and their repair can be technically complex. We have reported the redo repair of a large, expanding, right SAA after primary repair consisting of total aortic arch replacement with bilateral subclavian artery ligation and bypass. The redo repair used claviculectomy to facilitate exposure, ligation of the right deep cervical and internal thoracic arteries from within the aneurysm sac, and revision of the previous axillary artery bypass that had thrombosed owing to the mass effect of the expanding SAA. Claviculectomy can facilitate repair of large SAAs that are poorly suited to more routine exposure approaches, with acceptable risk and functional outcomes.

摘要

锁骨下动脉瘤(SAA)较为罕见,其修复在技术上可能很复杂。我们曾报道过一例大型、进行性增大的右侧SAA在初次修复(包括双侧锁骨下动脉结扎及旁路移植的全主动脉弓置换术)后的再次修复。再次修复采用锁骨切除术以利于暴露,在瘤腔内结扎右侧颈深动脉和胸廓内动脉,并对因进行性增大的SAA的占位效应而血栓形成的既往腋动脉旁路进行修复。锁骨切除术可促进对不太适合更常规暴露方法的大型SAA的修复,且风险和功能结果可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aa8/8556485/91a1557fdb39/gr1.jpg

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