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系统评价和荟萃分析右锁骨下动脉变异及其与颈胸临床状况的相关性。

Systematic review and meta-analysis of right subclavian artery variants and their correlation with cervical-thoracic clinical conditions.

机构信息

Department of Morphology, Faculty of Medicine, Universidad Andrés Bello, Santiago, Chile.

Department of Morphology and Function, Faculty of Health, University of the Americas Santiago, Chile.

出版信息

Medicine (Baltimore). 2024 Feb 23;103(8):e36856. doi: 10.1097/MD.0000000000036856.

Abstract

BACKGROUND

A high incidence of anatomical variations in the origin of the branches of the aortic arch has been reported, Nowadays, this variation is considered the most frequent in the aortic arch, its prevalence being estimated between 0.5% and 2.5% of the population. To understand its origin, knowledge of embryonic development is necessary.

METHODS

We searched the MEDLINE, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, and Latin-American literature and caribean of health sciences databases with dates ranging from their inception to June 2023. Study selection, data extraction, and methodological quality were assessed with the guaranteed tool for anatomical studies (Anatomical Quality Assurance). Finally, the pooled prevalence was estimated using a random effects model.

RESULTS

Thirty-nine studies were found that met the eligibility criteria. Twenty studies with a total of 41,178 subjects were included in the analysis. The overall prevalence of an ARSA variant was 1% (95% confidence interval = 1%-2%), the clinical findings found are that if ARSA is symptomatic it could produce changes in the hemodynamic function of the thoracocervical region in addition to other associated symptomatic complications in surrounding structures.

CONCLUSIONS

ARSA can cause several types of alterations in the cervical or thoracic region, resulting in various clinical complications, such as lusory dysphagia. Hence, knowing this variant is extremely important for surgeons, especially those who treat the cervico-thoracic region. The low prevalence of ARSA means that many professionals are completely unaware of its existence and possible course and origin. Therefore, this study provides detailed knowledge of ARSA so that professionals can make better diagnoses and treatment of ARSA.

摘要

背景

主动脉弓分支的解剖变异发生率很高,现已报道。目前,这种变异被认为是主动脉弓中最常见的变异,其患病率估计在人群中的 0.5%至 2.5%之间。为了了解其起源,需要了解胚胎发育的知识。

方法

我们在 MEDLINE、Scopus、Web of Science、Google Scholar、 Cumulative Index to Nursing and Allied Health Literature 以及拉丁美洲文献和加勒比健康科学数据库中进行了搜索,时间范围从数据库建立到 2023 年 6 月。使用解剖学质量保证(Anatomical Quality Assurance)这一保证解剖学研究的工具评估了研究选择、数据提取和方法学质量。最后,使用随机效应模型估计了汇总患病率。

结果

共发现 39 项符合入选标准的研究。共有 20 项研究,总计 41178 例受试者纳入分析。ARSA 变异的总体患病率为 1%(95%置信区间为 1%-2%),临床发现,如果 ARSA 有症状,它可能会导致胸颈区域的血液动力学功能发生变化,此外还可能导致周围结构的其他相关症状性并发症。

结论

ARSA 可导致颈或胸区域发生多种类型的改变,从而导致各种临床并发症,如假性吞咽困难。因此,了解这种变异对外科医生非常重要,尤其是治疗颈胸区域的外科医生。ARSA 的低患病率意味着许多专业人员完全不知道它的存在及其可能的发生和起源。因此,本研究提供了有关 ARSA 的详细知识,以便专业人员能够更好地诊断和治疗 ARSA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64bf/11309723/a050227cb707/medi-103-e36856-g001.jpg

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