Innominate artery aneurysm: axial reconstruction via a cervical approach.
True aneurysms of the innominate artery are rare. Successful axial reconstruction in the past has required a combined cervical and transthoracic approach with placement of a prosthetic graft. We describe herein the occurrence of an innominate artery aneurysm that extended to and involved the proximal common carotid artery and subclavian artery in a 63-year-old woman. The patient presented with thomboembolic sequelae in her fingertips and had a pulseless upper extremity. Successful aneurysmectomy and axial reconstruction with a bifurcated graft was achieved by using cervical exposure alone. A subsequent staged revascularization of the upper extremity was successfully accomplished with a brachial to radial artery bypass and ulnar artery transposition.
Takach
Thomas J
TJ
Department of Cardiothoracic and Vascular Surgery, Carolinas Heart Institute, Carolinas Health Care System, Charlotte, NC 28203, USA. tjtakach@netscape.net
Lalka
Stephen G
SG
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D001916:Brachial Artery / Q000601:surgery; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017534:Radial Artery / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation; D013348:Subclavian Artery / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017535:Ulnar Artery / Q000601:surgery