Yang Gen-Huan, Liao Peng-Zhi, Liu Xin-Nong, Wang Yan, Jia Yu-Long, Shen Chen-Yang
Department of Vascular Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Aug;46(4):554-559. doi: 10.3881/j.issn.1000-503X.16082.
Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneurysms and summarize the experience. Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 patients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed. Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0 (121.5,307.5) min.Intraoperative bleeding volume varied within 30-400 mL,with a median of 90 (50,125) mL.The time of carotid artery blocking and vertebral artery blocking varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0 (11.5,16.3) min and 25.0 (15.0,22.5) min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage occurred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5 (5.3,17.0) months.One patient with subclavian artery aneurysm developed artificial vessel occlusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery. Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.
目的 评估外科治疗颅外主动脉弓上动脉瘤的效果并总结经验。方法 收集2019年5月至2023年11月在首都医科大学附属北京天坛医院血管外科接受颅外主动脉弓上动脉瘤外科治疗的10例患者的临床资料。10例患者中，颈内动脉瘤5例，锁骨下动脉瘤2例，椎动脉动脉瘤2例，颈内动脉瘤合并同侧锁骨下动脉瘤1例。回顾性分析手术适应证、手术方案、临床疗效及并发症。结果 10例患者均手术成功，手术时间60～420分钟，中位手术时间180.0（121.5，307.5）分钟。术中出血量30～400毫升，中位出血量90（50，125）毫升。颈动脉阻断时间和椎动脉阻断时间分别为10～20分钟和20～30分钟，中位时间分别为15.0（11.5，16.3）分钟和25.0（15.0，22.5）分钟。围手术期未发生心脏意外、脑梗死或脑出血。10例患者随访3～58个月，中位随访时间8.5（5.3，17.0）个月。1例锁骨下动脉瘤患者术后20个月出现人工血管闭塞。1例颈内动脉瘤患者术后6个月出现颈内动脉远端狭窄。结论 颅外主动脉弓上动脉瘤应积极采用外科治疗，并根据患者情况制定个体化手术方案。
