Regina G, Fullone M, Testini M, Todisco C, Greco L, Rizzi R, Caruso G, Ettorre G C
Division of Vascular Surgery, University of Bari, Italy.
J Cardiovasc Surg (Torino). 1998 Dec;39(6):757-60.
Takayasu's arteritis is a chronic inflammatory disease of unknown etiology, which affects the aorta and its branches. The resulting lesions can be of steno-occlusive or aneurysmatic type; the latter form is relatively rare. The authors report 2 cases which came under their observation for treatment. The first was a young man of 22 years with aneurysm of the common right carotid artery and of the subclavian left intrathoracic artery. The carotid aneurysm was operated first; arterial reconstruction was ensured by means of a dacron bypass as the saphenous vein was not usable. Three months later, exeresis of the subclavian aneurysm was performed with a left thoracotomy in the IV space. The postoperative course was uneventful and no untoward event has been observed during follow-up (15 months). The second case was a young girl of 16 years with poststenotic aneurysmatic dilatation of the anonyma artery, tight stenosis of the left renal artery and occlusion of the right renal artery. The patient underwent median sternotomy and removal of the aneurysmatic wall together with the stenosis, and a dacron patch was applied. During preoperative angiography, the stenosis of the left renal artery had been treated with PTA; one month after the first operation, a right aorto-renal bypass was fashioned with the saphenous vein. Postoperative stay was free from complications on both occasions and complete normalization of the pressure values was obtained, which persists after 12 months.
高安动脉炎是一种病因不明的慢性炎症性疾病，累及主动脉及其分支。由此产生的病变可为狭窄闭塞型或动脉瘤型；后者相对少见。作者报告了他们观察到的2例接受治疗的病例。第一例是一名22岁的年轻人，右颈总动脉和左胸内锁骨下动脉患有动脉瘤。首先对颈动脉动脉瘤进行了手术；由于大隐静脉不可用，通过涤纶旁路确保了动脉重建。三个月后，通过在第四肋间进行左胸切开术切除了锁骨下动脉瘤。术后过程顺利，随访期间（15个月）未观察到不良事件。第二例是一名16岁的年轻女孩，无名动脉有狭窄后动脉瘤样扩张、左肾动脉严重狭窄和右肾动脉闭塞。患者接受了正中胸骨切开术，切除了动脉瘤壁及狭窄部分，并应用了涤纶补片。在术前血管造影时，左肾动脉狭窄已通过经皮腔内血管成形术（PTA）进行了治疗；第一次手术后一个月，用大隐静脉进行了右主动脉-肾旁路手术。两次术后住院均无并发症，血压值完全恢复正常，且在12个月后仍保持正常。
