腔内技术治疗Kommerell憩室的临床研究
|
摘要
目的探讨腔内技术治疗Kommerell憩室的可行性和安全性。方法回顾性分析首都医科大学宣武医院诊治的1例Kommerell憩室病变患者的临床资料、手术治疗过程及术后情况。结果根据Kommerell憩室不同的分型及临床症状,采取了有效的腔内治疗,成功行胸主动脉腔内覆膜支架隔绝并弹簧圈栓塞Kommerell憩室,术后主动脉血流通畅,完整隔绝瘤样病变,未发生内漏及颅内和上肢缺血。手术时间为55 min,术中出血量约为20 mL。术后第6天患者康复出院。出院后随访12个月时未发生内漏、头晕、上肢麻木等症状。结论针对不同类型Kommerell憩室及不同症状的患者,选择合适的腔内成形术可以有效治疗此类疾病,是可行且安全的。
Objective To evaluate efficacy and safety of treatment of Kommerell diverticulum with endovascular technique. Method The retrospective analysis was made on the preoperative clinical data, surgical treatment, and postoperative status of patient with Kommerell diverticulum who underwent the endovascular treatment in the Department of Vascular Surgery, Xuanwu Hospital of Capital Medical University. Results According to the different types and clinical symptoms, the effective endovascular treatment was adopted. The thoracic endovascular aortic repair and coil embolization of Kommerell diverticulum were successfully performed. The postoperative aortic blood flow was unobstructed and the aneurysmal lesion was completely isolated. No endoleakage and intracranial and upper limb ischemia were occurred. The operation time was 55 min and the blood loss was 20 mL. The patient was discharged on day 6 after the operation. No endoleakage, dizziness, and upper limb numbness were found following-up for 12 months.Conclusion For patient with different types of Kommerell diverticulum and different symptoms, who could be treated by appropriate endovascular treatment and it is effective and safety.
Objective To evaluate efficacy and safety of treatment of Kommerell diverticulum with endovascular technique. Method The retrospective analysis was made on the preoperative clinical data, surgical treatment, and postoperative status of patient with Kommerell diverticulum who underwent the endovascular treatment in the Department of Vascular Surgery, Xuanwu Hospital of Capital Medical University. Results According to the different types and clinical symptoms, the effective endovascular treatment was adopted. The thoracic endovascular aortic repair and coil embolization of Kommerell diverticulum were successfully performed. The postoperative aortic blood flow was unobstructed and the aneurysmal lesion was completely isolated. No endoleakage and intracranial and upper limb ischemia were occurred. The operation time was 55 min and the blood loss was 20 mL. The patient was discharged on day 6 after the operation. No endoleakage, dizziness, and upper limb numbness were found following-up for 12 months.Conclusion For patient with different types of Kommerell diverticulum and different symptoms, who could be treated by appropriate endovascular treatment and it is effective and safety.
引文
1 Omura A,Yoshida M,Matsuda H,et al.Acute type A aortic dissection in a patient with right aortic arch and an aberrant left subclavian artery arising from Kommerell diverticulum.Interact Cardiovasc Thorac Surg,2016,22(4):493-494.
2 Tanaka A,Milner R,Ota T.Kommerell's diverticulum in the current era:a comprehensive review.Gen Thorac Cardiovasc Surg,2015,63(5):245-259.
3白卫星,李天晓,翟水亭,等.主动脉Kommerell憩室数字减影造影分析及文献复习.当代医学,2010,16(5):18-20.
4 Backer CL,Bharadwaj SN,Eltayeb OM,et al.Double aortic arch with Kommerell diverticulum.Ann Thorac Surg,2019,108(1):161-166.
5 Silveira JV,Junqueira FP,Silveira CG,et al. Kommerell diverticulum:right aortic arch with anomalous origin of left subclavian artery and duplicity of right vertebral artery in a 16-year-old girl.Am J Case Rep,2019,20:228-232.
6 Salomonowitz E,Edwards JE,Hunter DW,et al.The three types of aortic diverticula.AJR Am J Roentgenol,1984,142(4):673-679.
7 Stone WM,Ricotta JJ 2nd,Fowl RJ,et al.Contemporary management of aberrant right subclavian arteries.Ann Vasc Surg,2011,25(4):508-514.
8 Tsukube T,Ataka K,Sakata M,et al.Surgical treatment of an aneurysm in the right aortic arch with aberrant left subclavian artery.Ann Thorac Surg,2001,71(5):1710-1711.
9 Gomes MM,Bernatz PE,Forth RJ.Arteriosclerotic aneurysm of an aberrant right subclavian artery.Dis Chest,1968,54(6):549-552.
10 Molz G,Burri B.Aberrant subclavian artery(arteria lusoria):sex differences in the prevalence of various forms of the malformation.Evaluation of 1 378 observations.Virchows Arch A Pathol Anat Histol,1978,380(4):303-315.
11 Kim KM,Cambria RP,Isselbacher EM,et al.Contemporary surgical approaches and outcomes in adults with Kommerell diverticulum.Ann Thorac Surg,2014,98(4):1347-54.
12 Backer CL,Monge MC,Popescu AR,et al.Vascular rings.Semin Pediatr Surg,2016,25(3):165-175.
13张少云,谢明星,贺林.超声诊断Kommerell憩室1例.临床超声医学杂志,2019,31(3):241.
14 Idrees J,Keshavamurthy S,Subramanian S,et al.Hybrid repair of Kommerell diverticulum.J Thorac Cardiovasc Surg,2014,147(3):973-976.
15 Backer CL,Hillman N,Mavroudis C,et al.Resection of Kommerell's diverticulum and left subclavian artery transfer forrecurrent symptoms after vascular ring division.Eur J Cardiothorac Surg,2002,22(1):64-69.
16 Gross RE.Surgical treatment for dysphagia lusoria.Ann Surg,1946,124:532-534.
17 Esposito RA,Khalil I,Galloway AC,et al.Surgical treatment for aneurysm of aberrant subclavian artery based on acase report and a review of the literature.Thorac Cardiovasc Surg,1988,95(5):888-891.
18 Barr JG,Sepehripour AH,Jarral OA,et al.A review of the surgical management of right-sided aortic arch aneurysms.Interact Cardiovasc Thorac Surg,2016,23(1):156-162.
19刘朝兵,张松林,胡旭,等.主动脉右弓右降合并Kommerell's憩室主动脉夹层1例报告.血管与腔内血管外科杂志,2017,3(5):1018-1019.
20 Bidar E,Arrigoni SC,Accord RE.Resection of Kommerell diverticulum and reimplantation of aberrant left subclavian artery in right aortic arch vascular ring.Semin Thorac Cardiovasc Surg,2018 Dec 7.pii:S1043-0679(18)30366-6.doi:10.1053/j.semtcvs.2018.11.015.
21 Ikeno Y,Koda Y,Yokawa K,et al.Graft replacement of Kommerell diverticulum and in situ aberrant subclavian artery reconstruction.Ann Thorac Surg,2019,107(3):770-779.
22 Rizza A,De Caterina AR,Murzi M,et al.Double carotidsubclavian bypass followed by endovascular exclusion of a Kommerell diverticulum and bilateral subclavian artery occlusion in a right-sided aortic arch.JACC Cardiovasc Interv,2019,12(9):e81-e82.
:23承文龙,原野,卢辉俊.杂交或腔内修复术治疗B型主动脉夹层合并迷走锁骨下动脉伴Kommerell憩室的疗效分析.中国普通外科杂志,2017,26(12):1541-1546.
24 Shingaki M,Kurimoto Y,Morishita K,et al.Anatomical repair for Kommerell diverticulum with deep site in-situ fenestration.Asian Cardiovasc Thorac Ann,2018,26(6):467-469.
25刘子豪.Stanford B型主动脉夹层腔内修复术中左锁骨下动脉处理的研究进展.中国普通外科杂志,2017,26(6):781-788.
26黄斌,吴洲鹏,赵纪春,等.腹主动脉瘤腔内修复术后B型内漏发生的危险因素分析及其处理.中国普外基础与临床杂志,2014,21(6):663-668.
27 Tempaku A,Kuroiwa T,Nishio A.Aberrant left subclavian artery occlusion in right-sided aortic artery associated with left cerebral infarction:A case report.Interv Neuroradiol,2018,24(3):322-326.
28 Gafoor S,Stelter W,Bertog S,et al.Fully percutaneous treatment of an aberrant right subclavian artery and thoracic aortic aneurysm.Vasc Med,2013,18(3):139-144.
29 Sun X,Zhang H,Zhu K,et al.Patient-specific three-dimensional printing for Kommerell's diverticulum.Int J Cardiol,2018,255:184-187.
30 Kozlov BN,Panfilov DS,Saushkin VV,et al.Mid-term results of hybrid treatment of aortic dissection combined with Kommerell's diverticulum.Khirurgiia(Mosk),2017,(11):72-76.
2 Tanaka A,Milner R,Ota T.Kommerell's diverticulum in the current era:a comprehensive review.Gen Thorac Cardiovasc Surg,2015,63(5):245-259.
3白卫星,李天晓,翟水亭,等.主动脉Kommerell憩室数字减影造影分析及文献复习.当代医学,2010,16(5):18-20.
4 Backer CL,Bharadwaj SN,Eltayeb OM,et al.Double aortic arch with Kommerell diverticulum.Ann Thorac Surg,2019,108(1):161-166.
5 Silveira JV,Junqueira FP,Silveira CG,et al. Kommerell diverticulum:right aortic arch with anomalous origin of left subclavian artery and duplicity of right vertebral artery in a 16-year-old girl.Am J Case Rep,2019,20:228-232.
6 Salomonowitz E,Edwards JE,Hunter DW,et al.The three types of aortic diverticula.AJR Am J Roentgenol,1984,142(4):673-679.
7 Stone WM,Ricotta JJ 2nd,Fowl RJ,et al.Contemporary management of aberrant right subclavian arteries.Ann Vasc Surg,2011,25(4):508-514.
8 Tsukube T,Ataka K,Sakata M,et al.Surgical treatment of an aneurysm in the right aortic arch with aberrant left subclavian artery.Ann Thorac Surg,2001,71(5):1710-1711.
9 Gomes MM,Bernatz PE,Forth RJ.Arteriosclerotic aneurysm of an aberrant right subclavian artery.Dis Chest,1968,54(6):549-552.
10 Molz G,Burri B.Aberrant subclavian artery(arteria lusoria):sex differences in the prevalence of various forms of the malformation.Evaluation of 1 378 observations.Virchows Arch A Pathol Anat Histol,1978,380(4):303-315.
11 Kim KM,Cambria RP,Isselbacher EM,et al.Contemporary surgical approaches and outcomes in adults with Kommerell diverticulum.Ann Thorac Surg,2014,98(4):1347-54.
12 Backer CL,Monge MC,Popescu AR,et al.Vascular rings.Semin Pediatr Surg,2016,25(3):165-175.
13张少云,谢明星,贺林.超声诊断Kommerell憩室1例.临床超声医学杂志,2019,31(3):241.
14 Idrees J,Keshavamurthy S,Subramanian S,et al.Hybrid repair of Kommerell diverticulum.J Thorac Cardiovasc Surg,2014,147(3):973-976.
15 Backer CL,Hillman N,Mavroudis C,et al.Resection of Kommerell's diverticulum and left subclavian artery transfer forrecurrent symptoms after vascular ring division.Eur J Cardiothorac Surg,2002,22(1):64-69.
16 Gross RE.Surgical treatment for dysphagia lusoria.Ann Surg,1946,124:532-534.
17 Esposito RA,Khalil I,Galloway AC,et al.Surgical treatment for aneurysm of aberrant subclavian artery based on acase report and a review of the literature.Thorac Cardiovasc Surg,1988,95(5):888-891.
18 Barr JG,Sepehripour AH,Jarral OA,et al.A review of the surgical management of right-sided aortic arch aneurysms.Interact Cardiovasc Thorac Surg,2016,23(1):156-162.
19刘朝兵,张松林,胡旭,等.主动脉右弓右降合并Kommerell's憩室主动脉夹层1例报告.血管与腔内血管外科杂志,2017,3(5):1018-1019.
20 Bidar E,Arrigoni SC,Accord RE.Resection of Kommerell diverticulum and reimplantation of aberrant left subclavian artery in right aortic arch vascular ring.Semin Thorac Cardiovasc Surg,2018 Dec 7.pii:S1043-0679(18)30366-6.doi:10.1053/j.semtcvs.2018.11.015.
21 Ikeno Y,Koda Y,Yokawa K,et al.Graft replacement of Kommerell diverticulum and in situ aberrant subclavian artery reconstruction.Ann Thorac Surg,2019,107(3):770-779.
22 Rizza A,De Caterina AR,Murzi M,et al.Double carotidsubclavian bypass followed by endovascular exclusion of a Kommerell diverticulum and bilateral subclavian artery occlusion in a right-sided aortic arch.JACC Cardiovasc Interv,2019,12(9):e81-e82.
:23承文龙,原野,卢辉俊.杂交或腔内修复术治疗B型主动脉夹层合并迷走锁骨下动脉伴Kommerell憩室的疗效分析.中国普通外科杂志,2017,26(12):1541-1546.
24 Shingaki M,Kurimoto Y,Morishita K,et al.Anatomical repair for Kommerell diverticulum with deep site in-situ fenestration.Asian Cardiovasc Thorac Ann,2018,26(6):467-469.
25刘子豪.Stanford B型主动脉夹层腔内修复术中左锁骨下动脉处理的研究进展.中国普通外科杂志,2017,26(6):781-788.
26黄斌,吴洲鹏,赵纪春,等.腹主动脉瘤腔内修复术后B型内漏发生的危险因素分析及其处理.中国普外基础与临床杂志,2014,21(6):663-668.
27 Tempaku A,Kuroiwa T,Nishio A.Aberrant left subclavian artery occlusion in right-sided aortic artery associated with left cerebral infarction:A case report.Interv Neuroradiol,2018,24(3):322-326.
28 Gafoor S,Stelter W,Bertog S,et al.Fully percutaneous treatment of an aberrant right subclavian artery and thoracic aortic aneurysm.Vasc Med,2013,18(3):139-144.
29 Sun X,Zhang H,Zhu K,et al.Patient-specific three-dimensional printing for Kommerell's diverticulum.Int J Cardiol,2018,255:184-187.
30 Kozlov BN,Panfilov DS,Saushkin VV,et al.Mid-term results of hybrid treatment of aortic dissection combined with Kommerell's diverticulum.Khirurgiia(Mosk),2017,(11):72-76.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |