Dayanır Onur Barış, Silistreli Erdem Erinç
Department of Cardiovascular Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):098-98. doi: 10.5606/tgkdc.dergisi.2024.mep-02. eCollection 2024 Nov.
Thromboangiitis obliterans (TAO) is a chronic, inflammatory and thrombotic vascular disease associated with tobacco use. This report described a TAO patient who underwent an aneurysmectomy due to a brachial artery aneurysm (BAA), which is not one of the classic findings of TAO and has no example in the literature. A 49-year-old male patient presented with swelling and pain in the right arm. In 2021, the patient was diagnosed with TAO. On physical examination, a pulsatile mass extending from the antecubital region was observed. Ultrasonography revealed aneurysmatic enlargement and mural thrombus (Figure1). Brachial aneurysmectomy was planned. The cephalic vein graft was interposed between the brachial artery and the radial artery. There was no flow issue. No postoperative complications were observed. The patient was discharged on the second day. Pathological examination was evaluated as compatible with TAO. After three months, the patient had no symptoms. Usually, BAA occurs due to arteriovenous fistula, trauma, or idiopathic causes. The TAO-specific findings in the pathological examination in this case is rare for BAA. Furthermore, BAA may contain specific pathological findings for TAO, which may be considered an atypical clinical presentation. Smoking may be a common etiological factor for TOA and BAA.
血栓闭塞性脉管炎(TAO)是一种与吸烟相关的慢性、炎症性和血栓性血管疾病。本报告描述了一名因肱动脉瘤(BAA)接受动脉瘤切除术的TAO患者,BAA并非TAO的典型表现之一,且文献中无相关病例。一名49岁男性患者出现右臂肿胀和疼痛。2021年,该患者被诊断为TAO。体格检查时,在前臂区域观察到一个搏动性肿块。超声检查显示动脉瘤样扩张和壁内血栓形成(图1)。计划进行肱动脉瘤切除术。将头静脉移植物置于肱动脉和桡动脉之间。未出现血流问题。未观察到术后并发症。患者于术后第二天出院。病理检查结果评估为与TAO相符。三个月后,患者无症状。通常,BAA是由动静脉瘘、创伤或特发性原因引起的。本例病理检查中TAO的特异性表现对于BAA来说较为罕见。此外,BAA可能包含TAO的特定病理表现,这可被视为一种非典型临床表现。吸烟可能是TAO和BAA的常见病因。