Dougherty M J, Calligaro K D, Savarese R P, DeLaurentis D A
Section of Vascular Surgery, Pennsylvania Hospital, Thomas Jefferson University, Philadelphia.
J Vasc Surg. 1995 Mar;21(3):521-9. doi: 10.1016/s0741-5214(95)70297-0.
True aneurysm of the subclavian artery is extremely rare. Excluding the more common aneurysms of an aberrant right subclavian artery, those associated with thoracic outlet syndrome, and posttraumatic "aneurysms," atherosclerosis is the most common cause. Syphilis, tuberculosis, and cystic medial necrosis are less often the cause. These aneurysms can rupture, thrombose, embolize, or cause symptoms by local compression. Surgical treatment is generally indicated, and has evolved from ligation procedures to extirpation or endoaneurysmorrhaphy to the present practice of resection with revascularization. A case of a surgically treated, asymptomatic, atherosclerotic aneurysm of the intrathoracic left subclavian artery is presented, with a review of the English-language literature on the subject.
锁骨下动脉真性动脉瘤极为罕见。排除较常见的迷走右锁骨下动脉动脉瘤、与胸廓出口综合征相关的动脉瘤以及创伤后“动脉瘤”,动脉粥样硬化是最常见的病因。梅毒、结核和囊性中膜坏死则较少成为病因。这些动脉瘤可破裂、形成血栓、发生栓塞或因局部压迫而引发症状。一般需进行手术治疗,其发展历程已从结扎术演变为切除术或动脉瘤内缝合法,直至如今采用切除并重建血管的做法。本文呈现了一例经手术治疗的无症状胸段左锁骨下动脉粥样硬化性动脉瘤病例,并对该主题的英文文献进行了综述。