动脉性胸廓出口综合征的临床表现、手术处理和结果:一个10年的机构经验

IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Harish Ayyavoo, B. Duraichi, N. Sritharan, K. Jayachander, P. Ilayakumar, S. Kumar, R. Venkatesh Babu, M. Ramya, P. Sujith
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引用次数: 0

摘要

目的:本研究的主要目的是回顾动脉胸廓出口综合征(TOS)的临床表现、外科治疗和手术治疗的结果。方法:回顾性分析我科(马德拉斯医学院血管外科研究所,金奈)2012年8月至2022年7月收治的动脉性TOS患者。结果:本研究共纳入81例患者,平均年龄41.13岁(12-65岁),其中男性占50.61%(41岁),女性占49.39%(40岁),伴远端动脉病变63例(77.77%),其中臂动脉闭塞占50.61%(33例),前臂动脉闭塞占24.69%(15例),腋下动脉闭塞占24.69%(15例)。95.06%的患者有颈肋(77例),2.46%的患者有第一肋异常(2例),2.46%的患者有软组织受压(2例),59.25%的患者为SCHER III期(48例),33.33%的患者为SCHER I期(27例),7.40%的患者为SCHER II期(6例)。所有患者均行锁骨上入路。最常见的动脉病变为锁骨下动脉(SCA)血栓(43例,53.08%)、闭塞(14例,17.28%)和扩张(24例,29.62%)。颈肋切除合并前斜角切除术占95.06%(77例),第一肋切除合并前斜角切除术占2.46%(2例),软组织切除合并前斜角切除术占2.46%(2例)。88.88%(72例)的病例进行了SCA干预/重建。2例患者行肘部以上截肢(2.46%),无死亡,SCA通畅率100%。结论:颈椎骨切除联合前斜角肌切除加或不加取栓是治疗动脉性TOS的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Arterial thoracic outlet syndrome - Clinical presentation, surgical management, and outcome: An institutional experience of 10-year period
Objective: The main objective of this study was to review the clinical presentations, surgical management, and outcome of surgical procedures for arterial thoracic outlet syndrome (TOS). Methodology: This is a retrospective analysis of arterial TOS patients admitted in our department (Institute of Vascular Surgery, Madras Medical College, Chennai) from August 2012 to July 2022. Results: This study enrolled 81 patients, with mean age of 41.13 (12-65 years) and 50.61% male (41) and 49.39% female (40), associated with distal arterial lesions - 63 (77.77%), among which 50.61% - occlusion in the brachial artery (33), 24.69% in forearm arteries (15), and 24.69% in the axillary artery (15). About 95.06% of patients had cervical rib (77), 2.46% - first rib abnormality (2), 2.46% - soft-tissue compression (2), 59.25% was SCHER Stage III (48), 33.33% SCHER stage I (27), and 7.40% SCHER stage II (6). All patients had undergone a supraclavicular approach. The most common arterial lesions were subclavian artery (SCA) thrombus in 53.08% (43), occlusion in 17.28% (14), and dilatation in 29.62% (24) cases. The cervical rib excision with anterior scalenectomy in 95.06% (77), and 1st rib excision with anterior scalenectomy 2.46% (2) and soft tissue resection with anterior scalenectomy 2.46% (2) of patients. SCA intervention/reconstruction was done in 88.88% (72) of cases. Two patients had underwent above elbow amputation (2.46%) and no mortality and SCA patency was 100%. Conclusion: Cervical rib excision with anterior scalenectomy with or without thrombectomy is an effective procedure for arterial TOS cases.
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