锁骨下动脉瘤的腔内治疗

Endovascular Therapy for Subclavian Artery Aneurysm

目的探讨锁骨下动脉瘤的腔内治疗价值。方法 2012年1月~2014年3月腔内治疗锁骨下动脉瘤8例,其中真性动脉瘤6例,假性动脉瘤2例。5例行覆膜支架,1例行覆膜支架联合裸支架,1例行降主动脉支架联合弹簧栓栓塞,1例行多层裸支架。结果 8例均顺利完成手术,无严重并发症。手术时间45~131 min,平均69.4 min;出血量10~120ml,平均30.0 ml。8例随访6~26个月,平均15个月,7例瘤腔完全血栓化,1例多层裸支架随访12个月,瘤腔有内漏,但瘤体直径无增大。结论腔内技术是治疗锁骨下动脉瘤的一个可行方法,需要根据瘤体大小及与主动脉、颈动脉、椎动脉的空间位置综合选择术式。

Objective To evaluate the value and efficacy of endovascular therapy for subclavian artery aneurysm （ SAA） . Methods From January 2012 to March 2014, endovascular therapy was performed in 8 cases of SAA （5 male and 3 female）, including 6 cases of true aneurysm and 2 cases of false aneurysm.Among them, 5 cases were treated with covered stent , 1 case with covered stent plus bare stent , 1 case with thoracic covered stent plus coil embolism , and 1 case with multilayer stent . Results Successful implementation of stents was achieved in all the 8 cases and no severe complications happened .The mean operation time was 69.4 min （range, 45-131 min）, and the mean blood loss was 30.0 ml （range, 10-120 ml）.The mean length of follow-up was 15 months （range, 6 -26 months）.The aneurysm sac was completely thrombosed in 7 cases, while endoleak without enlargement of aneurysm happened in 1 case that was treated with multilayer stent . Conclusion Endovascular therapy is an optional therapy to treat SAA, and the choice of the treatment should be based on the size and location of the aneurysm .