| Innominate artery occlusive disease: surgical approach and long-term results. | |
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MedLine Citation:
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PMID: 1831864 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We reviewed our experience with 54 patients who underwent innominate artery revascularization during a 10-year period. Their age range was from 16 to 75 years (mean, 49.8 years). The innominate artery alone was involved in 21 patients (39%); the remaining patients had additional arch vessel obstructions. Before operation, neurologic symptoms occurred in 25 patients (46%), arm ischemia related to claudication and microembolization occurred in 8 patients (14%), a combination of symptoms occurred in 17 patients (32%), and no symptoms were noted in 4 patients (8%). The extrathoracic approach to surgery was used in 16 patients (30%). Eleven of the 38 patients in whom the intrathoracic approach was used had endarterectomy of the innominate artery; in three of those, the procedure was combined with left common carotid endarterectomy. Bypass grafts were used in the other 27 patients undergoing procedures with an intrathoracic approach; in six of those, bypass was combined with carotid endarterectomy. No operative deaths occurred. Perioperative revascularization failure occurred in four cases; all of those patients underwent a second revascularization procedure, with a secondary patency rate of 100%. In four patients, late occlusion was noted at 6 months and at 1, 1.5, and 10 years. One patient had a permanent perioperative neurologic deficit in the distribution of the left carotid artery after a combined common carotid endarterectomy/innominate endarterectomy procedure. No neurologic deficits were directly related to the innominate artery territory. Long-term actuarial survival was 83% at 10 years. Early and late graft failures were related to inadequate inflow in bypass grafts, progression of distal disease in arteritis, and primary closure in endarterectomy. |
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Authors:
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G J Reul; M J Jacobs; I D Gregoric; M Calderon; J M Duncan; D A Ott; J J Livesay; D A Cooley |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of vascular surgery Volume: 14 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1991 Sep |
Date Detail:
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Created Date: 1991-10-03 Completed Date: 1991-10-03 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 405-12 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Texas Heart Institute, Houston 77225-0345. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aorta / surgery Arterial Occlusive Diseases / diagnosis, physiopathology, surgery* Blood Vessel Prosthesis Brachiocephalic Trunk / surgery* Constriction, Pathologic / diagnosis, physiopathology, surgery Endarterectomy Female Graft Occlusion, Vascular / etiology Humans Male Middle Aged Polyethylene Terephthalates Polytetrafluoroethylene Postoperative Complications Prognosis Survival Rate |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates; 9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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