A novel two-stage surgical approach for the treatment of symptomatic supra-aortic artery aneurysms.
We describe the case of a 45-year-old man with a unique constellation of supra-aortic artery aneurysms detected by chest X-ray during work-up for chronic cough. During his diagnostic work-up, the patient suffered an embolic stroke likely secondary to disrupted plaque originating in an aneurysmal right vertebral artery. Endovascular repair was not a viable option due to the diffuse and bilateral nature of aneurysmal disease, including involvement of the innominate and right carotid and vertebral arteries. The patient was successfully treated with a two-stage open surgical approach involving an initial right carotid artery to vertebral artery bypass and subsequent in situ reconstruction utilizing a bifurcated Dacron graft sewn to the proximal aortic arch with distal extension to the right common carotid and axillary arteries.
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Hospital of the University of Pennsylvana, PA 19104, USA.
Brant W
BW
Ullery
Paul J
PJ
Foley
Clay J
CJ
Brinster
Alberto
A
Pochettino
Ronald M
RM
Fairman
D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation*; D020521:Stroke / Q000209:etiology; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*