Porcellini M, Selvetella L, Scalise E, Bauleo A, Baldassarre M
Cattedra di Chirurgia Vascolare, Università degli Studi di Napoli, Federico I.
Minerva Cardioangiol. 1996 Sep;44(9):433-6.
To evaluate diagnostic investigations, operative management and long-term outcome of atherosclerotic aneurysms of the subclavian artery.
A retrospective clinical study through a follow-up period of 68 months (8 months to 11 years).
Department of Vascular Surgery, University Hospital.
Between 1983 and 1995, 5 patients with atherosclerotic aneurysms of the extrathoracic subclavian artery were reviewed. All patients presented a pulsatile supraclavicular mass. Ultrasonography and angiography confirmed the diagnosis and were useful in planning the operation.
Four patients were submitted, through a supraclavicular incision, to resection of the aneurysm and replacement of a prosthetic graft (dacron in 2 cases, PTFE in the remaining 2 cases). In one patient, with a small saccular aneurysm, a tangential aneurysmectomy with a patch angioplasty (PTFE) was performed.
All patients recovered after a mean hospital-stay of 9 days and had a valid radial pulsation. During the follow-up period, a dacron graft failure occurred 38 months later in one patient: she remains today asymptomatic.
Resection is today recommended for all patients with diagnosed subclavian artery aneurysms. Because of unknown natural history of asymptomatic aneurysms, with an unpredictable risk of complications, more accurate evaluations are required for optimal clinical decision making (early surgery vs watchful waiting?).
评估锁骨下动脉粥样硬化性动脉瘤的诊断检查、手术治疗及长期预后。
一项为期68个月（8个月至11年）的回顾性临床研究。
大学医院血管外科。
回顾了1983年至1995年间5例胸外锁骨下动脉粥样硬化性动脉瘤患者。所有患者均表现为锁骨上搏动性肿块。超声检查和血管造影确诊了病情，并有助于手术规划。
4例患者通过锁骨上切口接受了动脉瘤切除及人工血管置换术（2例使用涤纶人工血管，其余2例使用聚四氟乙烯人工血管）。1例患有小囊状动脉瘤的患者接受了带补片血管成形术（聚四氟乙烯）的切线状动脉瘤切除术。
所有患者平均住院9天后康复，桡动脉搏动良好。在随访期间，1例患者在38个月后出现涤纶人工血管失败：她目前仍无症状。
目前建议对所有诊断为锁骨下动脉瘤的患者进行手术切除。由于无症状动脉瘤的自然病史不明，并发症风险不可预测，因此需要更准确的评估以做出最佳临床决策（早期手术还是密切观察？）
