Tevfik GÜNEŞ, Muhammet AKYÜZ, Levent YILIK, Orhan GÖKALP, Ali GÜRBÜZ, İsmail YÜREKLİ

Surgical treatment of true aneurysms of subclavian and axillary arteries: results of eight cases

Amaç: Bu çalışmada subklaviyan ve aksiller arterlerin gerçek anevrizmaları incelendi.Çalışma planı: Şubat 1998 - Aralık 2007 tarihleri arasında subklaviyan ve aksiller arterin gerçek anevrizması nedeniyle ameliyat edilmiş sekiz hasta (6 erkek, 2 kadın; ort. yaş 58 yıl; dağılım 38-73 yıl) klinik ve ameliyat öncesi, sırası ve sonrası parametreler eşliğinde retrospektif olarak değerlendirildi.Bul gu lar: Altı hastada aksiller arter, iki hastada subklaviyan arter anevrizması vardı. Başvuru yakınmaları iki hastada (%25) iskemik semptomlar, üç hastada (%38) asemptomatik kitle, iki hastada (%25) bası hissi veren kitle ve bir hastada ise (%12) kanama idi. Etyolojik faktör beş hastada (%62) ateroskleroz, bir hastada (%13) muhtemel bağ dokusu hastalığı, iki hastada (%25) idiyopatik olarak tespit edildi. Medyan takip süresi 106 ay (dağılım 64-170 ay) idi. Ameliyata bağlı mortalite görülmedi. Bir hastada ameliyat sonrası 40. günde psödoanevrizma gelişti. Takip süresince sekonder greft açıklık oranı %100 idi.So nuç: Subklaviyan ve aksiller arterin gerçek anevrizmaları nadiren görülür. Bu patolojiler farklı etyolojik nedenler ve semptomlar ile ortaya çıkar. Tanı konulduktan sonra tedavi cerrahi olarak başarı ile gerçekleştirilebilir.

Subklaviyan ve aksiller arterin gerçek anevrizmaları ve cerrahi tedavisi: Sekiz olgunun sonuçları

Background: In this study, we investigated the true aneurysms of the subclavian and axillary arteries. Methods: Eight patients (6 males, 2 females; median age 58 years; range 38 to 73 years) who were operated due to true aneurysms of the subclavian and axillary arteries between February 1998 and December 2007 were examined retrospectively in terms of clinical and preoperative, intraoperative, postoperative parameters. Results: Six patients had axillary and two patients had subclavian artery aneurysms. Complaints on admission were ischemic symptoms in two patients (25%), asymptomatic mass in three (38%), feeling of compression in two (25%), and bleeding in one (12%). The etiological factor was atherosclerosis in five patients (62%), a probable connective tissue disorder in one (13%), and idiopathic in two (25%) patients. Median follow-up was 106 months (range, 64 to 170 months). No operative mortality was seen. One patient developed pseudoaneurysm on 40th postoperative day. Secondary graft patency rate was 100% during follow-up. Conclusion: True aneurysms of the subclavian and axillary arteries are rarely seen. These pathologies present with different etiological causes and symptoms. Following the diagnosis, treatment can be achieved by surgery successfully.

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