何明峰 高飞 马兴洲 田松朝 崔会青

摘 要：目的 探索左侧锁骨下动脉慢性闭塞的介入干预措施，为左侧锁骨下动脉慢性闭塞患者寻求更佳治疗手段，观察左侧锁骨下动脉慢性闭塞介入开通的治疗效果。方法 回顾性分析我院2012年3月～2017年10月收治的左侧锁骨下动脉慢性闭塞15例患者，对介入治疗的优点、左侧锁骨下动脉慢性闭塞的病因、治疗措施以及介入治疗开通的成功率、手术并发症等方面进行研究分析。结果 15例患者手术顺利，一期开通慢性闭塞的左侧锁骨下动脉，患者临床症状即刻或较快改善，无一例严重并发症的发生。结论 双入路和逆向开通的接入技术治疗左侧锁骨下动脉慢性闭塞安全、有效，具有成功率高、并发症少等优点。

关键词：介入治疗；左侧锁骨下动脉；慢性闭塞；逆向开通

中图分类号：R543.5 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.15.060

文章编号：1006-1959（2018）15-0178-03

Clinical Study of Double Approach and Reverse Opening for the Treatment of Chronic Occlusion of the Left Subclavian Artery

HE Ming-feng，GAO Fei，MA Xing-zhou，TIAN Song-chao，CUI Hui-qing

（Department of Neurology，the 371th Central Hospital of PLA，Xinxiang 453000，Henan，China）

Abstract：Objective To explore the interventional intervention for chronic occlusion of the left subclavian artery，and to seek a better treatment for patients with chronic occlusion of the left subclavian artery，and to observe the therapeutic effect of the intervention of chronic occlusion of the left subclavian artery.Methods Retrospective analysis of 15 patients with chronic occlusion of the left subclavian artery admitted to our hospital from March 2012 to October 2017 in our hospital.The advantages of interventional therapy， the cause of chronic occlusion of the left subclavian artery，treatment measures，and interventional therapy were opened.Research and analysis were carried out on success rates and surgical complications.Results 15 patients underwent successful operation.The first stage of the chronic occlusion of the left subclavian artery was opened.The clinical symptoms of the patients improved immediately or rapidly，and no serious complications occurred.Conclusion The double-entry and reverse-open access technologies are safe and effective in the treatment of chronic occlusion of the left subclavian artery，and have the advantages of high success rate and few complications.

Key words：Interventional therapy；Left subclavian artery；Chronic occlusion；Reverse opening

左側锁骨下动脉慢性闭塞临床上并不多见，它是因为各种原因导致左侧锁骨下动脉发生狭窄逐步发展为闭塞的一种病症。动脉粥样硬化是其主要病因[1]，其他病因见于大动脉炎、外伤、手术、先天畸形等等。由于左侧锁骨下动脉的闭塞导致血流障碍，其临床表现具有多样性，可以出现左手的麻木、无力、发凉、发紫等左上肢缺血的症状，也可以出现因为左侧椎动脉血流的逆行导致盗血事件的发生，患者出现头晕、眩晕、视物不清、甚至肢体瘫痪等锁骨下动脉盗血综合征的表现。该病内科治疗效果不佳，外科手术因创伤大、并发症多等缺点目前已经很少使用，介入治疗作为一种微创、安全、有效的治疗措施近年来已经成为首选[2，3]。……