Ann Ital Chir. 2021;92:709-714.
This paper retrospectively reviews our experience with endovascular and hybrid treatments for subclavian artery aneurysms (SAA).
Seventeen patients with SAAs were treated at our center between July 2011 and October 2018. Clinical and follow-up data were extracted from the hospital records and retrospectively reviewed. We routinely use endovascular treatments and stenting or axillary-axillary bypass to treat SAA if vertebral artery blood flow requires restoration. Patients were followed up at 3, 6, and 12 months after their operations and yearly thereafter.
Median follow-up was 30.5 months. In 6 patients, the SAAs involved the ipsilateral vertebral artery. Simple coil embolization was performed for 1 patient; endovascular covered stenting and coil embolization for 4 patients; and hybrid treatment for 1 patient. In 11 patients, the SAAs did not involve the ipsilateral vertebral artery. Hybrid treatment was performed for 1 patient; thoracic aortic stent implantation with coil embolization for 1 patient; and covered stent placement in the subclavian artery for 9 patients. Among the 9 patients who were symptomatic at presentation, 8 had relief of symptoms. Leakage was observed in 1 patient, but it stopped spontaneously. Stent occlusion occurred in 18.8% (3/16), but all were asymptomatic, and no interventions were necessary.
Endovascular and hybrid treatments appear to be effective for SAAs with few complications and good clinical outcomes.
Covered stent, Coil embolization, Endovascular treatment, Hybrid, Subclavian artery aneurysm.
本文回顾了我们采用血管内和杂交治疗策略治疗锁骨下动脉动脉瘤（SAA）的经验。
2011 年 7 月至 2018 年 10 月，我们中心收治了 17 例 SAA 患者。从病历中提取临床和随访数据，并进行回顾性分析。如果需要恢复椎动脉血流，我们通常采用血管内治疗和支架置入或腋-腋旁路转流来治疗 SAA。患者在术后 3、6 和 12 个月以及此后每年进行随访。
中位随访时间为 30.5 个月。6 例患者的 SAA 累及同侧椎动脉，单纯采用弹簧圈栓塞治疗 1 例，血管内覆膜支架置入联合弹簧圈栓塞治疗 4 例，杂交治疗 1 例。11 例患者的 SAA 不涉及同侧椎动脉，杂交治疗 1 例，胸主动脉支架置入联合弹簧圈栓塞治疗 1 例，锁骨下动脉覆膜支架置入 9 例。9 例患者有症状，8 例症状缓解。1 例患者出现漏，自发性停止。支架闭塞发生率为 18.8%（3/16），但均无症状，无需介入治疗。
血管内和杂交治疗策略治疗 SAA 并发症少，临床效果好。
覆膜支架；弹簧圈栓塞；血管内治疗；杂交；锁骨下动脉动脉瘤。
