Gruss J D, Geissler C
Abteilung für Gefässchirurgie, Kurhessisches Diakonissenhaus Kassel.
Zentralbl Chir. 1997;122(9):730-4.
The true subclavian artery aneurysm is a rare but dangerous complication of TOS. During a 20 years time period we observed 18 patients with subclavian artery aneurysms. 12 of these patients showed cervical ribs. Half of the patients (n = 9) presented with a critical ischemia of an upper extremity, nine patients were operated on electively. The acute ischemia makes the desobliteration of the outflow tract necessary first. The next step ist the transaxillary exarticulation of the first rib and the resection of the aneurysm. The reconstruction of the subclavian artery is performed by using autologous vein material or PTFE prostheses. In two cases both with an acute embolic critical ischemia major amputations were unavoidable. 13 patients could be reexamined in 1996: 11 bypasses proved to be functioning, 2 were definitely occluded.
真正的锁骨下动脉动脉瘤是胸廓出口综合征（TOS）一种罕见但危险的并发症。在20年的时间里，我们观察到18例锁骨下动脉动脉瘤患者。其中12例患者有颈肋。一半患者（n = 9）出现上肢严重缺血，9例患者接受了择期手术。急性缺血首先需要解除流出道阻塞。下一步是经腋路切除第一肋并切除动脉瘤。使用自体静脉材料或聚四氟乙烯（PTFE）假体进行锁骨下动脉重建。在两例急性栓塞性严重缺血的病例中，不可避免地进行了大截肢手术。1996年对13例患者进行了复查：11条旁路血管功能良好，2条完全闭塞。
