title: Successful hybrid management of extensive thromboembolism of the innominate trunk, right subclavian artery, bilateral common carotid artery, and pulmonary embolism.
abstract: Symptomatic acute carotid occlusion demands treatment, but the exact treatment to be provided in the case of acute occlusion of 3 supra-aortic vessels is not well established. Herein, we describe the successful emergency hybrid management of a massive thromboembolic occlusion of the right subclavian artery, common carotid artery, and innominate trunk, associated with left arm hemiparesis, motor aphasia, and confusion, and extensive pulmonary embolism. The diagnostic work-up and the hybrid surgical strategy adopted are described. Neurologic symptoms had completely regressed at discharge and the patient was free of any complications at the 3-month follow-up.
authors: Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy. Electronic address: emiliano.chisci@asf.toscana.it.
authors: Emiliano
authors: E
authors: Chisci
authors: Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy.
authors: Leonardo
authors: L
authors: Ercolini
authors: Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy.
authors: Eugenio
authors: E
authors: Romano
authors: Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy.
authors: Nicola
authors: N
authors: Troisi
authors: Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy.
authors: Stefano
authors: S
authors: Michelagnoli
mesh_terms: D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017128:Embolectomy; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017131:Thrombectomy; D013923:Thromboembolism / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014654:Vascular Patency