Pairolero P C, Walls J T, Payne W S, Hollier L H, Fairbairn J F
Surgery. 1981 Oct;90(4):757-63.
The records of all patients with aneurysm of the subclavian-axillary artery who were seen between January, 1960, and January, 1980, were reviewed. There were 31 patients (21 male and 10 female) with a mean age of 47 years. The aneurysm (mean size, 3.0 cm) was located on the right in 20 patients and on the left in 10; one patient had bilateral aneurysms. Mural thrombus was present in 25 patients. Eight patients were asymptomatic and 23 presented with upper extremity pain. Thromboembolism occurred in five patients, one presenting with impending loss of tissue. Two patients had the aneurysm rupture and one of them died. A pulsating mass was palpable in 20 patients, including the eight who were asymptomatic. Vocal cord paralysis occurred in two patients. The cause of the aneurysm was atherosclerosis in 12 patients, trauma in 10, poststenotic dilation secondary in thoracic outlet obstruction in 6, mycotic aneurysm in 2, and Ehlers-Danlos syndrome in one patient. Seven patients had nine aneurysms in other areas. Surgical treatment consisted of thoracic outlet decompression in 4 patients, graft interposition in 11, tangential aneurysmorrhaphy in 8, ligation in 4, and exploratory surgery only in one. One forearm amputation was subsequently performed. Three patients did not undergo surgery. Average length of follow-up was 9.2 years. Except for the patient who underwent amputation, all treated patients had adequate circulation in the extremities. No aneurysm recurred and no complication of the repair developed. We conclude that aneurysms of the subclavian-axillary artery, although rare, are both life- and limb-threatening. Resection and arterial reconstruction are recommended.
回顾了1960年1月至1980年1月期间所有锁骨下-腋动脉动脉瘤患者的记录。共有31例患者（男性21例，女性10例），平均年龄47岁。动脉瘤（平均大小3.0 cm）位于右侧20例，左侧10例；1例患者为双侧动脉瘤。25例患者存在壁血栓。8例患者无症状，23例表现为上肢疼痛。5例患者发生血栓栓塞，1例出现组织即将坏死。2例患者动脉瘤破裂，其中1例死亡。20例患者可触及搏动性肿块，包括8例无症状患者。2例患者出现声带麻痹。动脉瘤的病因在12例患者中为动脉粥样硬化，10例为创伤，6例为胸廓出口梗阻继发的狭窄后扩张，2例为霉菌性动脉瘤，1例为埃勒斯-当洛综合征。7例患者在其他部位有9个动脉瘤。手术治疗包括4例胸廓出口减压、11例移植血管置入、8例动脉瘤切线缝合、4例结扎，仅1例为探查手术。随后进行了1例前臂截肢术。3例患者未接受手术。平均随访时间为9.2年。除接受截肢术的患者外，所有接受治疗的患者肢体循环良好。无动脉瘤复发，修复也未出现并发症。我们得出结论，锁骨下-腋动脉动脉瘤虽然罕见，但对生命和肢体均构成威胁。建议进行切除和动脉重建。
