scholarly journals Case Report: Aberrant Left Vertebral Artery Management in Traumatic Transection of the Aortic Isthmus

2019 ◽  
Vol 22 (6) ◽  
pp. E481-E485
Author(s):  
Ovidiu Stiru ◽  
Liana Valeanu ◽  
Catalina Andreea Parasca ◽  
Roxana Carmen Geana ◽  
Platon Pavel ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Preoperative Planning ◽  
Left Subclavian Artery ◽  
Left Vertebral Artery ◽  
Stent Grafts ◽  
Landing Zone ◽  
Aortic Isthmus ◽  
Traumatic Pseudoaneurysm ◽  
Post Traumatic ◽  
Traumatic Transection

Association of elective debranching and endovascular thoracic aortic repair (TEVAR) with aberrant left vertebral artery (AVA) revascularization and supra-aortic left carotid-subclavian bypass in post-traumatic pseudoaneurysm of the distal aortic arch are extremely rare procedures that can minimize unnecessary neurologic complications. The patient was a 42-year-old man, stable, with a post-traumatic transection of the aortic isthmus, with origin of the AVA between the left common carotid artery (LCCA) and left subclavian artery (LSA). Preoperative planning and proper sizing of the stent-grafts were evaluated by means of computed tomography angiography (CT scan) images. The patient underwent a hybrid procedure that included TEVAR with landing zone 2, covering the origin of both the AVA and LSA and concomitant supra-aortic reimplantation of the AVA in the LCCA and left carotid-subclavian bypass combined with both ligation of the AVA and LSA proximally. Postoperative arteriography images confirmed the exclusion of the aneurysm and the patency of all arch vessels, including the AVA. No endoleak was reported.

scholarly journals Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Virendra Budhiraja ◽  
Rakhi Rastogi ◽  
Vaishali Jain ◽  
Vishal Bankwar ◽  
Shiv Raghuwanshi
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Left Vertebral Artery ◽  
Common Trunk ◽  
Branching Pattern ◽  
Brachiocephalic Trunk

Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases.

A 3-Dimensional Printed Aortic Arch Template to Facilitate the Creation of Physician-Modified Stent-Grafts

2018 ◽  
Vol 25 (5) ◽  
pp. 554-558 ◽  
Author(s):  
Pawel Rynio ◽  
Arkadiusz Kazimierczak ◽  
Tomasz Jedrzejczak ◽  
Piotr Gutowski
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Left Subclavian Artery ◽  
Thoracic Endovascular Aortic Repair ◽  
Stent Grafts ◽  
Landing Zone ◽  
3 Dimensional ◽  
Improve Accuracy ◽  
3D Printed ◽  
Radiopaque Markers

Purpose: To demonstrate the utility of a 3-dimensional (3D) printed template of the aortic arch in the construction of a fenestrated and scalloped physician-modified stent-graft (PMSG). Case Report: A 73-year-old woman with descending thoracic aneurysm was scheduled for thoracic endovascular aortic repair after being disqualified for open surgery. Computed tomography angiography (CTA) revealed no proximal landing zone as the aneurysm began from the level of the left subclavian artery, so a fenestrated/scalloped PMSG was planned. To facilitate accurate placement of the openings in the graft, a 3D printed aortic arch template was prepared from the CTA data and gas sterilized. In the operating room, a Valiant stent-graft was inserted into the 3D printed template and deployed. Using ophthalmic cautery, a fenestration and a scallop were created; radiopaque markers were added. The PMSG was successfully deployed with no discrepancy between the openings and the target vessels. Conclusion: A 3D printed aortic arch template facilitates handmade fenestrations and scallops in PMSGs and may improve accuracy and quality.

scholarly journals Morphological characteristics of the aortic arch organization

2013 ◽  
Vol 19 (2) ◽  
pp. 67-73 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Left Vertebral Artery ◽  
Morphological Aspect ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right ◽  
Number Of Branches

Abstract Our study was performed on 228 cases by dissection, by plastic injection followed by corrosion or dissection and by simple and CT angiography study. Each morphological aspect was assessed on a different numbers of cases, as long as the same case could not provide data on all studied elements. We assessed: the number of branches that originate from the aortic arch, the level of origin and the morphological type of the aortic arch. In terms of number of branches emerging from the aortic arch, most commonly are three branches, in 48.48% of cases, describing them 3 variations: separation of the three classical branches in 45,96% of cases, in 1.51% of cases the left common carotid artery emerged from the brachiocephalic trunk while the other two branches being represented by a vertebral artery and the left subclavian and in 1.01% by the right subclavian artery with retroesophageal traject, by a bicarotid arterial trunk and the left subclavian artery. In 28.70% of the cases were four branches, as follows: in 13.13% of cases the fourth branch was represented by the left vertebral artery, in 7.07% of cases there was the inferior thyroid artery, in 4.04% of cases the brachiocephalic arterial trunk was missing and the right subclavian artery originate from the aortic arch and presented a retroesophageal traject, in 3.03% of cases the fourth artery was the ascending cervical and in 1.51% of cases all four arteries had their origins in the aortic arch with no brachiocephalic trunk. In 22.73% of cases from the aortic arch originated only two branches: in 19.70% of cases the left common carotid originated in the brachiocephalic trunk, so the second branch was the left subclavian and in 3.03% of the cases there were two brachiocephalic trunks. Regarding the level of origin from the aortic arch, we found that only the brachiocephalic arterial trunk showed versions of origin: in 64 61% of the cases the brachiocephalic trunk had its origin in the horizontal segment of the aortic arch, in 21.54% of cases the origin was located at the limit between the ascending and horizontal segments and vin 12.31% of cases the origin was from the ascending segment of the aortic arch. In only 1.54% of the cases the left subclavian artery originated from the descending segment of the aortic arch

Intentional Left Subclavian Artery Occlusion by Thoracic Aortic Stent-Grafts without Surgical Transposition

2001 ◽  
Vol 8 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Klaus A. Hausegger ◽  
Peter Oberwalder ◽  
Kurt Tiesenhausen ◽  
Josef Tauss ◽  
Olaf Stanger ◽  
...  
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Case Reports ◽  
Artery Occlusion ◽  
Left Vertebral Artery ◽  
Stent Grafts ◽  
Subclavian Artery Occlusion ◽  
Limited Experience ◽  
Type B Dissection

Purpose: To report the consequences of endoluminal deployment of stent-grafts in the thoracic aorta with intentional occlusion of the left subclavian artery. Case Reports: Three patients with an aortic type-B dissection and 1 with a thoracic aneurysm were treated endoluminally with Talent stent-grafts implanted over the ostium of the left subclavian artery without prior surgical subclavian-carotid transposition. The primary intimal tears were sealed and the degenerative aneurysm excluded; blood pressure in the left arm was significantly diminished immediately after the stent-graft was released, but adequate collateral retrograde perfusion via the left vertebral artery was apparent in all patients. No neurological deficit and no symptoms of left arm ischemia were observed in a follow-up that ranged from 14 to 20 months. Conclusions: Our limited experience shows that occlusion of the left subclavian artery with a stent-graft is well tolerated. If ischemic symptoms occur, a transposition procedure can be performed on an elective basis.

MDCT detection of left subclavian artery obstruction accompanied by anomalous origin of the left vertebral artery

2007 ◽  
Vol 115 (2) ◽  
pp. 244-245 ◽  
Author(s):  
Yosuke Omori ◽  
Sei Komatsu ◽  
Tomokazu Murakawa ◽  
Atsushi Hirayama ◽  
Yuichi Sato ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Anomalous Origin ◽  
Left Vertebral Artery ◽  
Artery Obstruction

scholarly journals Post Traumatic Pseudoaneurysm Arising from V4 Segment of Vertebral Artery: A Case Report

2015 ◽  
Vol 11 (2) ◽  
pp. 154
Author(s):  
Chae Wook Huh ◽  
Kyoung Hyup Nam ◽  
Chang Hwa Choi ◽  
Jae Il Lee
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Traumatic Pseudoaneurysm ◽  
Post Traumatic

scholarly journals Carotid ultrasound features of anomalous left vertebral artery originating from the aortic arch proximal to the left subclavian artery

2017 ◽  
Vol 30 (2) ◽  
pp. 168-171
Author(s):  
Masayuki Wakita ◽  
Ran Takei ◽  
Fumio Miyashita ◽  
Yuki Hamada ◽  
Satoshi Ohyama ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vertebral Artery ◽  
Left Subclavian Artery ◽  
Three Dimensional ◽  
Cervical Vertebra ◽  
Duplex Ultrasound ◽  
Left Vertebral Artery ◽  
Carotid Ultrasound ◽  
Transverse Foramen ◽  
Ultrasound Features

We present three cases of anomalous origin of the left vertebral artery (LVA) detected during the evaluation of stroke. The VA usually enters the transverse foramen of the sixth cervical vertebra (C6), but an anomalous LVA originating from the aorta frequently enters at a higher level. In our series, ultrasound of the LVA showed entry at C4 in two patients and at C5 in one patient. These findings suggested anomalous LVA origin, and three-dimensional computed tomography demonstrated the LVA arising from the aorta proximal to the left subclavian arteries. Carotid duplex ultrasound is useful for the diagnosis of this anomaly.

scholarly journals Two Cases of Left Vertebral Artery Emerging from a Trunk in Common with the Left Subclavian Artery from the Aortic Arch

2013 ◽  
Vol 31 (2) ◽  
pp. 646-649
Author(s):  
Nicolás Ernesto Ottone ◽  
Leandro Casola ◽  
Vanina Cirigliano ◽  
Lucero Oloriz ◽  
Esteban Daniel Blasi ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Left Vertebral Artery

scholarly journals Anomalous Origin of the Left Vertebral Artery from the Aortic Arch

Aorta ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 64-67 ◽  
Author(s):  
Evan Einstein ◽  
Linda Song ◽  
Natalia Villela ◽  
Gregory Fasani-Feldberg ◽  
Jonathan Jacobs ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Prevalence Rate ◽  
Left Subclavian Artery ◽  
Anatomical Variation ◽  
Left Vertebral Artery ◽  
Surgical Practice

AbstractAnatomic anomalies of the aortic arch have implications for clinical practice if their significance is understood. Our case study involves a cadaveric finding of the left vertebral artery originating directly from the aortic arch. Although this anatomical variation has been documented, the prevalence of this anomaly may be generally underestimated. After noting this anomaly, we analyzed 27 cases and found that four female cadavers had the left vertebral artery originating from the aortic arch rather than the left subclavian artery. With a prevalence rate of 14.8%, it would seem that this anomaly is more significant than previously thought, which could have implications for surgical practice.

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