Document Detail


Innominate artery occlusive disease: surgical approach and long-term results.
MedLine Citation:
PMID:  1831864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  14     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1991-10-03     Completed Date:  1991-10-03     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  405-12     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Texas Heart Institute, Houston 77225-0345.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Polyethylene Terephthalates; 9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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