Ohtake H, Urayama H, Kimura K, Nakata K, Kawasuji M, Watanabe Y
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Panminerva Med. 1997 Sep;39(3):222-5.
We report an 80-year-old woman, with pseudoaneurysm of the right proximal subclavian artery despite the absence of a history of trauma. On preoperative examinations, the aneurysm involved to the common carotid arteries. A long temporary bypass using a heparin-coated tube from the right femoral artery to the right common carotid artery was created under low dose systemic heparinization. A Dacron bifurcation graft bypassing was then performed successfully. At surgery for right proximal subclavian artery aneurysm, which often involves the right common carotid artery, intraoperative accident or bleeding can induce brain ischemia. A temporary bypass should be prepared. Although the short temporary bypass from the aorta to the right common carotid artery was reported, this carries the risk of complications due to microemboli. The heparin-coated tube provided excellent anti-thrombosis. Inflow cannulation should be placed at the peripheral artery not the aorta.
我们报告了一位80岁女性，尽管没有外伤史，但右锁骨下动脉近端出现了假性动脉瘤。术前检查显示，动脉瘤累及颈总动脉。在低剂量全身肝素化的情况下，使用肝素涂层管从右股动脉至右颈总动脉建立了一条长的临时旁路。随后成功进行了涤纶分叉移植物旁路手术。在右锁骨下动脉近端动脉瘤手术中，该动脉瘤常累及右颈总动脉，术中意外或出血可导致脑缺血。应准备临时旁路。虽然有报道从主动脉至右颈总动脉建立短的临时旁路，但这存在微栓子导致并发症的风险。肝素涂层管具有出色的抗血栓形成作用。流入插管应置于外周动脉而非主动脉。
