Subclavian artery-axillary aneurysm
Introduction
Introduction of subclavian artery- aneurysm The aneurysm at the distal end of the subclavian artery often involves the first radial artery, called subclavian-axillary aneurysm. The most common cause is the thoracic outlet syndrome caused by the cervical rib and the fiber cord. Seen in young women, more common to the right. basic knowledge The proportion of illness: 0.1% - 0.2% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Inferior subclavian artery- aneurysm
(1) Causes of the disease
The formation of the subclavian artery- aneurysm is mostly related to the cervical rib (Fig. 1). Other causes include abnormal first rib, non-union of the clavicle and other anatomical abnormalities that cause thoracic outlet syndrome. According to statistics, the neck The incidence of ribs is about 0.6% in the crowd, most of them do not cause clinical symptoms. Women often have aneurysm formation and are more common on the right side. At the same time, 50% to 80% of cervical ribs are bilateral. This causes the subclavian artery- aneurysm to also be bilateral.
(two) pathogenesis
The cervical rib is anatomically fused with the first rib through a fiber bundle, a bone joint, a movable joint, etc., and the external compression and angulation are caused by the subclavian artery passing through the first rib, and the aneurysm-like change is caused by the expansion after the stenosis. Involving the distal and proximal radial artery of the subclavian artery; the thrombus in the aneurysm can cause arterial embolization of the distal limb. In some cases, the aneurysm cavity can be completely occluded due to thrombosis, and the anterior extension leads to vertebral artery embolism. And the right carotid artery embolism, symptoms of central nervous system appear.
Prevention
Subclavian artery- aneurysm prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Subclavian artery- aneurysm complications Complication
The subclavian artery-radial artery can be fatally ruptured; intratumoral thrombosis causes acute and chronic ischemia of the upper limbs and brain, and compression of the brachial plexus, often threatening the patient's life and limbs.
Symptom
Subclavian artery- aneurysm symptoms Common symptoms Pulsating mass scapular scapula and upper extremity pain weakness upper limb numb upper limb weakness spinal nerve compression tremor upper limb edema upper limb suddenly appeared swelling sore ulnar artery or radial artery...
Clinical manifestations are diverse. Some patients have thoracic outlet syndrome as the main manifestation. For example, compression nerves may cause upper limb pain, numbness, weakness, and upper limb swelling may occur when compression of the subclavian vein; some patients may have acute and chronic ischemic symptoms of upper limbs. , pale, cold, painful, or manifested by Raynaud, severe cases of rest pain, gangrene or ulcers.
Physical examination can affect the abnormal neck rib of the supraclavicular fossa, tremor of the subclavian artery; auscultation can smell loud and rough murmur, if there is distal arterial embolization, the pulsation of the radial artery, radial artery and ulnar artery can be weakened or disappeared.
Examine
Examination of the subclavian artery- aneurysm
X-ray inspection
(1) Chest flat: can confirm bone abnormalities.
(2) arteriography: should include the aortic arch and upper extremity arteries, can determine the existence and extent of the tumor, the location of the distal arterial embolization and the condition of the output vascular, which is the main basis for the preoperative planning, but the contrast Coanda thrombosis is not well judged.
2. Doppler inspection
Can be used as a routine examination to find subclavian artery stenosis and stenosis and expansion.
Diagnosis
Diagnosis and diagnosis of subclavian artery- aneurysm
In this disease, a pulsatile mass should be found on the clavicle. In addition to the mediastinal tumor, the common carotid artery of the subclavian artery is distorted and expanded, the disease can be considered. X-ray can confirm bone abnormality. B-ultrasound and CT often have diagnosis and differential diagnosis. Important value.
The subclavian artery- aneurysm must be differentiated from the distorted dilatation of the common carotid artery of the subclavian artery. In addition, the upper mediastinal mass shown on the chest radiograph should be differentiated from other tumors.
