CAJ | 학술논문

目的：探讨腔内治疗右锁骨下动脉狭窄和闭塞的手术指征、特点和疗效。方法：选择2009年3月—2013年3月复旦大学附属中山医院诊治的右锁骨下动脉狭窄和闭塞患者21例，局麻下腔内治疗后1个月、3个月时门诊随访，此后每隔半年门诊随访，行踝肱指数（ankle-brachial index，ABI）、彩超检查或 CT 血管成像（CT angiography，CTA）检查。结果：21例患者中右锁骨下动脉闭塞性病变7例，狭窄性病变14例。2例右锁骨下动脉闭塞患者因导丝无法通过闭塞段病变而仅行造影，其余19例均成功行腔内治疗，总成功率为90．5％。19例行腔内治疗的患者术后平均随访19．3个月，通畅率为89．5％（17／19），中度再狭窄率为10．5％（2／19），无支架断裂和打折，无病死病例。结论：右锁骨下动脉狭窄和闭塞有其特殊的解剖学特点，腔内治疗是一种有效的治疗方法。
목적：탐토강내치료우쇄골하동맥협착화폐새적수술지정、특점화료효。방법：선택2009년3월—2013년3월복단대학부속중산의원진치적우쇄골하동맥협착화폐새환자21례，국마하강내치료후1개월、3개월시문진수방，차후매격반년문진수방，행과굉지수（ankle-brachial index，ABI）、채초검사혹 CT 혈관성상（CT angiography，CTA）검사。결과：21례환자중우쇄골하동맥폐새성병변7례，협착성병변14례。2례우쇄골하동맥폐새환자인도사무법통과폐새단병변이부행조영，기여19례균성공행강내치료，총성공솔위90．5％。19례행강내치료적환자술후평균수방19．3개월，통창솔위89．5％（17／19），중도재협착솔위10．5％（2／19），무지가단렬화타절，무병사병례。결론：우쇄골하동맥협착화폐새유기특수적해부학특점，강내치료시일충유효적치료방법。
Objective:To analyze and discuss the indication,features and efficacy of endovascular treatment for right subclavian artery stenosis and occlusion.Methods:From Mar 2009 to Mar 2013,a total of 21 patients with right subclavian artery stenosis and occlusion treated in Zhongshan Hospital,Fudan University were enrolled.Patients were given endovascular treatment under local anesthesia.Patients were followed up at 1 month and 3 months after operation and then every 6 months,and ankle-brachial index(ABI)and doppler ultrasonography or CT angiography(CTA)scan were done.Results:Of the 21 cases,there were 7 pa-tients with chronic total occlusion(CTO)and 14 patients with severe stenosis.And 2 cases with CTO had only received angiog-raphy,because the guidewire could not pass through.The other 19 patients successfully underwent endovascular treatment.The success rate was 90.5% in all.The mean followed-up period was 19.3 months with a patency rate of 89.5%(17/19)and a mod-erate restenosis rate of 10.5%(2/19).There was no death,no stent broken or fracture.Conclusions:Right subclavian artery stenosis and occlusion has some special anatomic features,the short-to medium-term outcomes of endovascular treatment are satisfied.