scholarly journals A Rare Case of an Ascending Aorta and Aortic Arch Aneurysm with an Aberrant Right Common Carotid Artery

2021 ◽  
Vol 30 (1) ◽  
pp. 13-21
Author(s):  
Mikhail M. Olalo ◽  
Syril Bren P. Guillermo
Keyword(s):  
Back Pain ◽  
Chest Pain ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Incidental Finding ◽  
Aortic Arch Aneurysm ◽  
Aortic Aneurysms ◽  
Custom Made ◽  
Arch Aneurysm

Ascending aortic aneurysms are asymptomatic and are usually discovered as an incidental finding on chest imaging. However, larger aneurysms can present with symptoms resulting from compression of surrounding structures including the trachea, bronchi, and the esophagus which can result in hoarseness, cough chest pain or back pain. The presence of an aortic arch anomaly, specifically an aberrant right common carotid artery, in a background of an aortic arch aneurysm is extremely rare with a worldwide incidence of <1%. They are usually asymptomatic but can result to catastrophic life threatening events and pose significant challenges to surgical or endovascular treatment. This is a case of a 63-year old Filipino male who presented with a sudden onset of dull back pain radiating to the left anterior chest. Workup revealed an ascending and aortic arch aneurysm with an aberrant right common carotid artery arising directly from the transverse aorta. Surgical aortic arch debranching was done to repair the aberrant vessels prior to Thoracic Endovascular Aortic Repair (TEVAR) wherein a custom-made Thoracic Valiant graft was deployed on the aneurysm. The patient was discharged on the 4th day after TEVAR without any complaints of dyspnea, back pain nor chest pain with no neurologic and visceral organ dysfunction. This case has emphasized that knowledge on the anatomy of the aortic arch is imperative in planning out thoracic surgery and endovascular interventions especially on rare anatomic anomalies such as seen in this case. Keywords aortic aneurysm, aberrant right common carotid artery, TEVAR

Trans-Carotid Placement of Balloon Expandable Covered Stent for Unplanned Left Carotid Coverage during Endovascular Repair of Distal Arch Aneurysm

2015 ◽  
Vol 10 (3) ◽  
pp. 209-211
Author(s):  
Ganesh S. Kumpati ◽  
David A. Bull ◽  
Amit N. Patel
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Common Carotid Artery ◽  
Covered Stent ◽  
Aortic Arch Aneurysm ◽  
Left Common Carotid Artery ◽  
Endovascular Management ◽  
Distal Aortic Arch Aneurysm ◽  
Arch Aneurysm

We present a technique for endovascular management of unplanned coverage of the left common carotid artery during endovascular repair of a distal aortic arch aneurysm. A balloon expandable covered stent was placed into the proximal left common carotid artery by neck incision.

Preoperative construction of an extracranial arterial shunt for resection of an aortic arch aneurysm with occluded left carotid artery

2003 ◽  
Vol 76 (4) ◽  
pp. 1298-1301
Author(s):  
Hisato Takagi ◽  
Yoshio Mori ◽  
Yukio Umeda ◽  
Yukiomi Fukumoto ◽  
Yoshimasa Mizuno ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Aortic Arch Aneurysm ◽  
Left Carotid Artery ◽  
Arch Aneurysm

scholarly journals Endovascular Stent Grafting for Aortic Arch Aneurysm in Aortoiliac Occlusive Disease following Aortic Arch Debranching and Aortobifemoral Reconstruction

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Didem Melis Oztas ◽  
Cagla Canbay ◽  
Yilmaz Onal ◽  
Metin Onur Beyaz ◽  
Omer Ali Sayin ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Alternative Therapy ◽  
Aortic Arch Aneurysm ◽  
Aortic Aneurysms ◽  
Endovascular Stent ◽  
Aortoiliac Occlusive Disease ◽  
Mortality And Morbidity ◽  
Stent Grafting ◽  
Endovascular Stent Grafting ◽  
Arch Aneurysm

Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient. In these situations stent grafting may even be more complicated. In this report, we present the treatment of a 92-year-old patient with aortic arch aneurysm and proximal descending aortic aneurysm. For successful thoracic endovascular stent grafting, the patient needed an alternative route other than the native femoral and iliac arteries for the deployment of the stent graft. In addition, debranching of left carotid and subclavian arteries from the aortic arch was also required for successful exclusion of the thoracic aneurysm.

Arch branch endografts for arch aneurysms associated with bovine anomaly

2018 ◽  
Vol 27 (2) ◽  
pp. 127-131
Author(s):  
Y Law ◽  
YC Chan ◽  
SW Cheng
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Treatment Options ◽  
Custom Made ◽  
Management Modality ◽  
Extracorporeal Bypass ◽  
Arch Aneurysm ◽  
Bovine Aortic Arch ◽  
Invasive Management ◽  
Bovine Arch

Bovine aortic arch is known to be associated with an increased rate of aortic arch expansion. The most frequently observed human variant of bovine aortic arch is a common origin of the innominate trunk and left common carotid artery. This is a report of two patients who had successful custom-made arch branch endograft treatment for an arch aneurysm associated with bovine arch anomaly. Modular endovascular repair of aortic arch aneurysms using an inner-branched device adds to the armamentarium of treatment options, and is a minimally invasive management modality without the need for sternotomy or intraoperative extracorporeal bypass.

Fenestrated TEVAR Using a Guidewire Fixator for Anchoring in Aortic Arch Target Vessels

2017 ◽  
Vol 25 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Tilo Kölbel ◽  
Linus Bosaeus ◽  
Nikolaos Tsilimparis ◽  
Franziska Heidemann ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Endovascular Repair ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Left Common Carotid Artery ◽  
Target Vessel ◽  
Arch Aneurysm

Purpose: To report a new facilitated method for securing target vessel access during single fenestrated and branched thoracic endovascular repair using a guidewire fixator. Technique: The Liungman Guidewire Fixator (LGF) includes a 0.035-inch guidewire that is fitted with a stopper close to the distal end and a self-expanding anchoring element that is freely movable over the guidewire to the point of the stopper. The technique of using a LGF for anchoring in a target vessel is described in a 75-year-old woman with a 53-mm saccular arch aneurysm. She was treated with a fenestrated Zenith stent-graft that had a catheter-preloaded fenestration for the left subclavian artery (LSA) and a scallop for the left common carotid artery. To avoid through-and-through wire and brachial access, the LGF was used to secure the guidewire in the LSA during stent-graft deployment. Conclusion: The use of an LGF for anchoring in the target LSA during fenestrated arch endografting was feasible and safe.

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

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