乳腺动脉的生命线:隐藏的大动脉封闭的附带依赖如何改变了再血管化策略
Georgia R Layton1, Ajaay Shrinivas2, Ibrahim Antoun3
1Department of Cardiac Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
JACC. Case reports
|December 3, 2025
概括
术前CT血管造影对于识别罕见的血管疾病至关重要,这些疾病可以在冠状动脉旁路移植 (CABG) 期间使内部乳腺动脉的收获变得危险. 这种成像可以预防高风险患者的灾难性缺血.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 内部乳腺动脉是冠状动脉旁路移植 (CABG) 的标准动脉导管.
- 未被识别的心脏外血管病理可能会导致CABG期间的灾难性并发症,如果内部乳腺动脉被收获.
研究的目的:
- 要强调手术前成像在高风险CABG候选人的重要性.
- 展示如何识别关键的附带网络可以防止意外的管道收获和危及生命的缺血.
主要方法:
- 一名61岁的男性患者患有非ST段升高心肌梗塞,被评估为CABG.
- 手术前的计算机断层扫描 (CT) 血管图显示完全的下大动脉封闭,通过右侧内乳腺动脉和其他附带血管进行广泛的附带输液.
- 由于潜在的灾难性缺血症,CABG被认为风险过高.
主要成果:
- 患者接受了分阶段的皮肤冠状动脉干预,并成功康复.
- 电脑图谱血管学发现了一个关键的附带网络,该网络可能会受到内部乳腺动脉收获的损害.
结论:
- 对于高风险的CABG候选人来说,CT成像是至关重要的,特别是那些有外周动脉疾病迹象的人.
- 通过CT动脉图识别复杂的附带循环可以保护导管选择并防止外科手术期间的损害.
- 个性化冠状动脉管理至关重要,因为标准指导方针可能不涵盖复杂的解剖变异.
相关概念视频
Blood Flow
57.4K
Blood is pumped by the heart into the aorta, the largest artery in the body, and then into increasingly smaller arteries, arterioles, and capillaries. The velocity of blood flow decreases with increased cross-sectional blood vessel area. As blood returns to the heart through venules and veins, its velocity increases. The movement of blood is encouraged by smooth muscle in the vessel walls, the movement of skeletal muscle surrounding the vessels, and one-way valves that prevent backflow.
57.4K
Regulation of Angiogenesis and Blood Supply
2.9K
Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits. Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl...
2.9K
Structure of Blood Vessels
11.8K
Blood is circulated throughout the human body through a network of blood vessels called the circulatory system. This system includes arteries that transport blood from the heart to various body parts. These arterial pathways divide into smaller vessels until they reach the arterioles, which further split into capillaries. It is within these minuscule capillaries that the exchange of nutrients and waste products takes place. After this exchange, the blood is collected by venules, which fuse to...
11.8K
Arteries and Arterioles
8.2K
Arteries, the vasculature responsible for transporting blood from the heart, possess robust walls capable of enduring the elevated pressures exerted by the heartbeat. Arteries near the heart are especially thick-walled and enriched with elastic fibers across their three tunics, classifying them as elastic or conducting arteries. These arteries, usually with a diameter exceeding 10 mm, are characterized by their ability to dilate in response to the blood pumped from the heart's ventricles...
8.2K
Autoregulation of Blood Flow
10.0K
Autoregulation mechanisms are characterized by their inherent capacity for self-regulation without necessitating specific nervous stimulation or endocrine control. These mechanisms facilitate the adjustment of blood flow and, therefore, perfusion specific to each tissue region. This self-regulation encompasses chemical signals and myogenic controls.
Chemical Signaling in Autoregulation
Chemical signaling operates at the precapillary sphincter level, inciting either contraction or relaxation....
Chemical Signaling in Autoregulation
Chemical signaling operates at the precapillary sphincter level, inciting either contraction or relaxation....
10.0K
Abdominal Aorta
3.5K
Once the aorta traverses the diaphragmatic plane at the aortic hiatus, it is known as the abdominal aorta. This anatomical structure is positioned leftward of the spinal column, encased within a cocoon of adipose tissue behind the peritoneal cavity. It terminates at the L4 vertebra, where it splits into the common iliac arteries. Prior to this bifurcation, the abdominal aorta gives rise to several vital branches.
The celiac trunk, a singular artery, divides into the left gastric artery, which...
The celiac trunk, a singular artery, divides into the left gastric artery, which...
3.5K


