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一例被误诊为原发性雷诺现象的胸廓出口综合征动脉型病例。

A case of misdiagnosed arterial thoracic outlet syndrome as primary Raynaud's phenomenon.

作者信息

Balram Amrita, Ng Jyi Cheng, Ochuba Arinze, Ho Kevin, Lum Ying Wei

机构信息

The Johns Hopkins University, Baltimore, MD.

Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang, Malaysia.

出版信息

J Vasc Surg Cases Innov Tech. 2024 Apr 16;10(4):101508. doi: 10.1016/j.jvscit.2024.101508. eCollection 2024 Aug.

DOI:10.1016/j.jvscit.2024.101508
PMID:38812728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11133972/
Abstract

Arterial thoracic outlet syndrome (aTOS) is a rare, but potentially, limb-threatening condition that is often misdiagnosed. We present the case of a 29-year-old man who was initially managed under the presumption of primary Raynaud's phenomenon for >1 year before the correct diagnosis of aTOS, and the delay in diagnosis was complicated by substantial distal thromboembolic occlusion. Successful staged treatment included thoracic outlet decompression, subclavian artery aneurysm repair with subclavian-to-axillary bypass, anticoagulation, and an unconventional axillary-to-ulnar artery bypass. This report highlights the diagnostic challenges of aTOS and the importance of considering it in patients with Raynaud's phenomenon and vaso-occlusive symptoms.

摘要

动脉型胸廓出口综合征（aTOS）是一种罕见但可能危及肢体的疾病，常被误诊。我们报告一例29岁男性病例，该患者最初被误诊为原发性雷诺现象并接受治疗超过1年，之后才确诊为aTOS，诊断延迟导致严重的远端血栓栓塞性闭塞。成功的分期治疗包括胸廓出口减压、锁骨下动脉动脉瘤修复并进行锁骨下至腋动脉搭桥、抗凝治疗以及非常规的腋动脉至尺动脉搭桥。本报告强调了aTOS的诊断挑战以及在患有雷诺现象和血管闭塞症状的患者中考虑该病的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/89e52570b3fe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/c3d18e9a0f58/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/f16a3bd7e546/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/5266659cc9bf/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/93f26998b593/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/89e52570b3fe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/c3d18e9a0f58/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/f16a3bd7e546/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/5266659cc9bf/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/93f26998b593/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad5/11133972/89e52570b3fe/gr5.jpg

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本文引用的文献

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