Hennerici M, Aulich A, Sandmann W, Lerut J
Dtsch Med Wochenschr. 1981 Dec 11;106(50):1697-703. doi: 10.1055/s-2008-1070579.
Direct comparison with neuroradiologic and surgical data show that stenoses and occlusions of the innominate trunk may be recognized safely by Doppler ultrasound despite localisation close to the aorta. Formation of sonographically demonstrable and haemodynamically complicated vascular by-passes is the reason for the mainly asymptomatic or very uncharacteristic complaints of these cases (78%) among the relatively rare stenosing occlusions of the lumen (0,65%) of the innominate trunk (18 out of 2768 patients). Only in four cases were there focal neurological losses or symptoms of hypoperfusion of the arm. Invasive diagnostic measures should thus be used sparingly. The indication for vascular surgery should be limited to a few cases as long as the natural course of these extracranial vascular changes and the risk of cerebral injury have not been established with certainty.
与神经放射学和手术数据的直接比较表明,尽管无名动脉干靠近主动脉,但通过多普勒超声仍可安全识别其狭窄和闭塞情况。在无名动脉干管腔相对罕见的狭窄闭塞(2768例患者中有18例,占0.65%)中,超声可显示且血流动力学复杂的血管旁路形成是这些病例中主要无症状或非常不典型症状(78%)的原因。仅4例出现局灶性神经功能丧失或手臂灌注不足症状。因此,应谨慎使用侵入性诊断措施。只要这些颅外血管变化的自然病程和脑损伤风险尚未明确确定,血管手术的适应症就应限于少数病例。