CAJ | 학술논문

目的探讨胸主动脉疾病腔内修复术中封闭左锁骨下动脉的可行性及效果.方法 2005年10月-2012年3月广州军区武汉总医院心胸外科对行胸主动脉腔内修复术需要封闭左锁骨下动脉的患者在术前进行脑循环、颈动脉、椎基底动脉及Willis环检查,如右侧椎动脉血供良好,颈动脉、Willis环无狭窄则选择在腔内修复术中直接封闭左锁骨下动脉.术后观察颅脑及上肢缺血并发症发生情况.结果 40例患者封闭了左锁骨下动脉,手术均获成功,28例术后未出现左上肢窃血症状和神经系统并发症,12例出现了轻微的左上肢窃血症状及神经系统并发症,但无需手术干预.结论在有意封闭左锁骨下动脉前,必须注意潜在性主动脉弓上各分支动脉的病变和变异,这样才可能保证胸主动脉疾病患者进行主动脉腔内修复术时安全、有效.
목적 탐토흉주동맥질병강내수복술중봉폐좌쇄골하동맥적가행성급효과.방법 2005년10월-2012년3월엄주군구무한총의원심흉외과대행흉주동맥강내수복술수요봉폐좌쇄골하동맥적환자재술전진행뇌순배、경동맥、추기저동맥급Willis배검사,여우측추동맥혈공량호,경동맥、Willis배무협착칙선택재강내수복술중직접봉폐좌쇄골하동맥.술후관찰로뇌급상지결혈병발증발생정황.결과 40례환자봉폐료좌쇄골하동맥,수술균획성공,28례술후미출현좌상지절혈증상화신경계통병발증,12례출현료경미적좌상지절혈증상급신경계통병발증,단무수수술간예.결론 재유의봉폐좌쇄골하동맥전,필수주의잠재성주동맥궁상각분지동맥적병변화변이,저양재가능보증흉주동맥질병환자진행주동맥강내수복술시안전、유효.
Objective To investigate the feasibility and effect of intentional occlusion of the left subclavian artery (LSA) in endovascular aortic repair EVAR of thoracic aortic disease.Methods The cases,who needed occlusion of the LSA in EVAR of thoracic aortic disease,were examined cerebral circulation,carotid artery,vertebral basilar artery and circle of Willis.If the vertebral artery had a good blood pathway,and carotid artery and circle of Willis had no stenotic,we occluded the LSA directly in EVAR,and observed the brain and upper limb ischemia complications postoperation.Results Among 40 cases who were occluded the LSA directly in EVAR,28 cases were successful with no neurological complications and left upper limb ischemia symptoms postoperation,12 patients with mild symptoms of subclavian steal syndrome and neurdogical complications,but none required and secondary surgical intervention.Conclusions Prior to intentional LSA occlusion,attention must be paid to potential supraaortic variants and pathologies.Only in this way,it was safe and effective to occlude the LSA in EVAR of thoracic aortic disease.