Two-Stage Redo Aortic Arch Repair in a Patient With an Isolated Left Vertebral Artery

2020 ◽  
Vol 15 (4) ◽  
pp. 376-378
Author(s):  
Hidetake Kawajiri ◽  
Mohammad A. Khasawneh ◽  
Thomas C. Bower ◽  
Gabor Bagameri
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
False Lumen ◽  
Computed Tomographic Angiography ◽  
Left Vertebral Artery ◽  
Acute Type ◽  
Computed Tomographic ◽  
Aortic Arch Repair ◽  
Tomographic Angiography ◽  
Arch Reconstruction

A 47-year-old male presented with an enlarging distal aortic arch false lumen 6 months status post ascending and hemiarch replacement with antegrade endograft insertion for acute type A aortic dissection complicated by lower body malperfusion. Preoperative computed tomographic angiography showed an isolated but dominant left vertebral artery. A 2-stage open surgical repair was performed. First, the left subclavian artery was transposed on the common carotid and vertebral onto the subclavian. At the second stage, a redo total arch reconstruction was done with bypass grafts taken to the innominate and left common carotid arteries. The patient did well postoperatively.

Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography

2013 ◽  
Vol 24 (3) ◽  
pp. 485-493 ◽  
Author(s):  
Alper Karacan ◽  
Aysel Türkvatan ◽  
Keziban Karacan
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Computed Tomographic Angiography ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Branching Pattern ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Type 3

AbstractPurpose: The aim of this study was to investigate the frequency and gender distribution of variations in the aortic arch branching pattern using 64-slice computed tomograhic angiography. Materials and methods: A total of 1000 patients with a normal left-sided aortic arch who underwent computed tomographic angiography for various reasons were analysed retrospectively for the frequency of variation of aortic arch branching; the variations were categorised into seven types. Results: Of the 1000 patients, 79.2% had a normal aortic arch branching pattern – type 1 – and 20.8% had variations. The frequency of type 2 variation – brachiocephalic and left common carotid arteries arising from the aortic arch in a common trunk – was 14.1%, that of type 3 – left vertebral artery originating from the aortic arch – was 4.1%, that of type 4 – coexistence of type 2 and type 3 – was 1.2%, that of type 5 – aberrant right subclavian artery – was 0.6%, that of type 6 – coexistence of aberrant right subclavian artery and bicarotid trunk – was 0.7%, and that for type 7 – thyroidea ima artery arising from the aortic arch – was 0.1%. The incidences of the variations of aortic arch branching were similar among males and females (20% versus 22.1%). The incidence of an aberrant right subclavian artery – type 5 and type 6 – was higher among females compared with males (2.5% versus 0.5), whereas the frequencies of the other variations were either equal or similar in both genders. Conclusion: Recognition of variations of aortic arch branching is important because they may cause symptoms due to tracheoesophageal compression or complications during surgical or endovascular interventional procedures of the aorta and its branches.

scholarly journals Cilostazol plus clopidogrel in the prevention of in-stent stenosis after vertebral artery origin stenting in gout patients: three case reports

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096580
Author(s):  
Huai-Wu Yuan ◽  
Ya-Jie Lin ◽  
Ren-Jie Ji
Keyword(s):  
Vertebral Artery ◽  
Case Reports ◽  
Bare Metal Stents ◽  
Computed Tomographic Angiography ◽  
Metal Stents ◽  
Computed Tomographic ◽  
History Of ◽  
Tomographic Angiography ◽  
Age Range ◽  
Stent Stenosis

It is unclear whether cilostazol instead of aspirin in combination with clopidogrel could prevent in-stent thrombosis in patients with a history of gout undergoing vertebral artery origin stenting. Three men (age range, 58–74 years) were diagnosed with acute ischaemic stroke or transient ischaemic attack. Vertebral artery origin stenosis was visible by computed tomographic angiography or digital subtraction angiography. Four bare metal stents were placed in the vertebral artery origin. The patients were administered 100 mg cilostazol orally twice a day and 75 mg clopidogrel orally once a day perioperatively and 100 mg cilostazol orally twice day was administered indefinitely after 3 months. No in-stent stenosis was observed in all of these patients during a follow-up period up to 19 months. Cilostazol plus clopidogrel has the potential to become an alternative to standard dual antiplatelet therapy in vertebral artery origin stenting. A high-quality clinical trial is needed to verify these preliminary findings.

scholarly journals Isolated left vertebral artery and its consequences for aortic arch repair

2019 ◽  
Vol 5 (3) ◽  
pp. 369-371
Author(s):  
Emma van der Weijde ◽  
Olaf J. Bakker ◽  
Uday Sonker ◽  
Robin H. Heijmen
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Left Vertebral Artery ◽  
Aortic Arch Repair

scholarly journals Management of isolated dissection of the abdominal aorta: a single-centre experience

2020 ◽  
Vol 31 (6) ◽  
pp. 827-833
Author(s):  
Yingliang Wang ◽  
Dehan Liu ◽  
Tianhe Ye ◽  
Xiangjun Dong ◽  
Yangbo Su ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
False Lumen ◽  
Computed Tomographic Angiography ◽  
Technical Success Rate ◽  
Therapeutic Modalities ◽  
Computed Tomographic ◽  
Abdominal Aortic ◽  
Partial Thrombosis ◽  
Tomographic Angiography

Abstract OBJECTIVES Isolated abdominal aortic dissection (IAAD) is a rare disease. Currently, there is no consensus on the management of IAAD. Our goal was to report our experience with the management of IAAD. METHODS A cohort of 45 consecutive patients with IAAD was treated between January 2010 and December 2018. We reviewed the demographics, clinical features, therapeutic modalities and follow-up results. RESULTS A total of 33 patients had successful endovascular repair (EVAR) and 12 patients underwent conservative treatment initially. During a mean follow-up of 16.6 months, 2 of the patients in the EVAR group had endoleak; neither of them needed reintervention. Complete or partial thrombosis of the false lumens was seen in all patients (88% and 12%) on the latest computed tomographic angiography images, and a significant enlargement of the true lumen and regression of the false lumen and maximal abdominal aortic diameter were observed in all patients (P < 0.001). In the group receiving conservative treatment, 3 patients were lost to follow-up; 1 patient died; 2 patients had small re-entry sites, neither of which needed intervention; 1 patient had EVAR; and the others remain symptom-free. The latest computed tomographic angiography images showed that 1 patient had spontaneous healing with complete thrombosis of the false lumen, 7 patients had partial thrombosis and the diameter of the maximal abdominal aortic and false lumen remained stable or was less decreased. CONCLUSIONS For patients with IAAD, close surveillance is necessary. In addition, EVAR is an effective therapeutic method with a high technical success rate and low complication rate for carefully selected patients.

Computed Tomographic Angiography for the Diagnosis of Blunt Carotid/Vertebral Artery Injury

2007 ◽  
Vol 246 (4) ◽  
pp. 632-643 ◽  
Author(s):  
Ajai K. Malhotra ◽  
Marc Camacho ◽  
Rao R. Ivatury ◽  
Ivan C. Davis ◽  
Daniel J. Komorowski ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Tomographic Angiography

Left cervical aortic arch in conjunction with a complex arch aneurysm and subaortic left innominate vein

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Türkvatan ◽  
Ü. Kervan ◽  
Ölçer ◽  
Cumhur ◽  
Sarıtaş
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Artery Aneurysm ◽  
Computed Tomographic Angiography ◽  
Innominate Vein ◽  
Computed Tomographic ◽  
Subclavian Artery Aneurysm ◽  
Left Innominate Vein ◽  
Tomographic Angiography ◽  
Arch Aneurysm

We present a patient with left cervical aortic arch who had a complex aortic arch aneurysm consisting of multiple saccular aneurysmatic excavations, proximal aortic arch narrowing, a right subclavian artery aneurysm and subaortic left innominate vein diagnosed by computed tomographic angiography.

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