title: Complex reconstruction of supraaortic branches.
abstract: OBJECTIVE
  The present paper exemplary describes several severe stenoses of supraaortic branches with its symptoms and operative treatments.
  
  
  METHODS
  Eight patients, two female (68 ± 5 y), six male (73 ± 4 y), were retrospectively evaluated. Patients showed neurological signs as followed: recurring attacks of vertigo (80%), temporary paresis of extremity (20%), speech disorders (20%) and subclavian and/or carotic-steel-syndrome (15%). Seven patients have already been previously treated with revascularization of the supraaortic branches in the past. The surgical techniques used were thrombendarterectomy of the internal carotid artery, carotid-subclavian bypass and complex aorto-truncal, aorto-carotid and aorto-subclavian-bypass.
  
  
  RESULTS
  One patient died nine days postoperatively due to myocardial infarction. Mean duration of stay on intensive care unit was 1.5 days. Mean duration of postoperative ventilation was six hours. Average duration of stay on normal ward was nine days.
  
  
  CONCLUSIONS
  This study presents several complex reconstructions of supraaortic branches, which were indicated in cases with severe stenoses of supraaortic branches. Even though treatment strategies were complex the peri- and postoperative complication rates are quite low. These therapeutic strategies were necessary to avoid severe neurological complications in these patients.
authors: Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen, Goettingen, Germany.
authors: Masoud
authors: M
authors: Mirzaie
authors: Sheila
authors: S
authors: Fatehpur
authors: Martin
authors: M
authors: Friedrich
authors: Samuel
authors: S
authors: Sossalla
authors: Christian
authors: C
authors: Sohns
authors: Friedrich A
authors: FA
authors: Schoendube
authors: Jan D
authors: JD
authors: Schmitto
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003251:Constriction, Pathologic; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality