Alternatives in the management of atherosclerotic occlusive disease of aortic arch branches

Robert Kozol, C. E. Bredenberg

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The cases of 62 patients with atherosclerotic occlusive disease at the origin of the aortic arch branches were reviewed. Thirty-six were initially without neurologic symptoms and in four (11%) intermittent neurologic symptoms without stroke developed during an average follow-up of 27 months. No patient had limb-threatening ischemia. Twenty-six operations were performed for neurologic symptoms or disabling limb ischemia, with one death. Five-year graft patency by life-table analysis was 81%. Preoperative or late postoperative stroke in three patients with occluded common carotid artery suggests this to be a more dangerous subgroup. We advise surgery for patients with disabling arm symptoms or with ischemic neurologic symptoms associated with multiple-vessel disease or with major lesions in the innominate-carotid circulation. We advocate selective revascularization with priority given to the innominate-carotid flow. Isolated subclavian lesions first seen as a single lesion or as the only residual lesion after reconstruction for multiple-vessel disease can be safely left unreconstructed.

Original languageEnglish
Pages (from-to)1457-1460
Number of pages4
JournalArchives of Surgery
Volume116
Issue number11
StatePublished - Dec 1 1981
Externally publishedYes

Fingerprint

Neurologic Manifestations
Thoracic Aorta
Ischemia
Extremities
Stroke
Life Tables
Common Carotid Artery
Arm
Transplants

ASJC Scopus subject areas

  • Surgery

Cite this

Alternatives in the management of atherosclerotic occlusive disease of aortic arch branches. / Kozol, Robert; Bredenberg, C. E.

In: Archives of Surgery, Vol. 116, No. 11, 01.12.1981, p. 1457-1460.

Research output: Contribution to journalArticle

Kozol, Robert ; Bredenberg, C. E. / Alternatives in the management of atherosclerotic occlusive disease of aortic arch branches. In: Archives of Surgery. 1981 ; Vol. 116, No. 11. pp. 1457-1460.
@article{172389dc901041c29f21a2ea0a21a38e,
title = "Alternatives in the management of atherosclerotic occlusive disease of aortic arch branches",
abstract = "The cases of 62 patients with atherosclerotic occlusive disease at the origin of the aortic arch branches were reviewed. Thirty-six were initially without neurologic symptoms and in four (11{\%}) intermittent neurologic symptoms without stroke developed during an average follow-up of 27 months. No patient had limb-threatening ischemia. Twenty-six operations were performed for neurologic symptoms or disabling limb ischemia, with one death. Five-year graft patency by life-table analysis was 81{\%}. Preoperative or late postoperative stroke in three patients with occluded common carotid artery suggests this to be a more dangerous subgroup. We advise surgery for patients with disabling arm symptoms or with ischemic neurologic symptoms associated with multiple-vessel disease or with major lesions in the innominate-carotid circulation. We advocate selective revascularization with priority given to the innominate-carotid flow. Isolated subclavian lesions first seen as a single lesion or as the only residual lesion after reconstruction for multiple-vessel disease can be safely left unreconstructed.",
author = "Robert Kozol and Bredenberg, {C. E.}",
year = "1981",
month = "12",
day = "1",
language = "English",
volume = "116",
pages = "1457--1460",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "11",

}

TY - JOUR

T1 - Alternatives in the management of atherosclerotic occlusive disease of aortic arch branches

AU - Kozol, Robert

AU - Bredenberg, C. E.

PY - 1981/12/1

Y1 - 1981/12/1

N2 - The cases of 62 patients with atherosclerotic occlusive disease at the origin of the aortic arch branches were reviewed. Thirty-six were initially without neurologic symptoms and in four (11%) intermittent neurologic symptoms without stroke developed during an average follow-up of 27 months. No patient had limb-threatening ischemia. Twenty-six operations were performed for neurologic symptoms or disabling limb ischemia, with one death. Five-year graft patency by life-table analysis was 81%. Preoperative or late postoperative stroke in three patients with occluded common carotid artery suggests this to be a more dangerous subgroup. We advise surgery for patients with disabling arm symptoms or with ischemic neurologic symptoms associated with multiple-vessel disease or with major lesions in the innominate-carotid circulation. We advocate selective revascularization with priority given to the innominate-carotid flow. Isolated subclavian lesions first seen as a single lesion or as the only residual lesion after reconstruction for multiple-vessel disease can be safely left unreconstructed.

AB - The cases of 62 patients with atherosclerotic occlusive disease at the origin of the aortic arch branches were reviewed. Thirty-six were initially without neurologic symptoms and in four (11%) intermittent neurologic symptoms without stroke developed during an average follow-up of 27 months. No patient had limb-threatening ischemia. Twenty-six operations were performed for neurologic symptoms or disabling limb ischemia, with one death. Five-year graft patency by life-table analysis was 81%. Preoperative or late postoperative stroke in three patients with occluded common carotid artery suggests this to be a more dangerous subgroup. We advise surgery for patients with disabling arm symptoms or with ischemic neurologic symptoms associated with multiple-vessel disease or with major lesions in the innominate-carotid circulation. We advocate selective revascularization with priority given to the innominate-carotid flow. Isolated subclavian lesions first seen as a single lesion or as the only residual lesion after reconstruction for multiple-vessel disease can be safely left unreconstructed.

UR - http://www.scopus.com/inward/record.url?scp=0019774490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019774490&partnerID=8YFLogxK

M3 - Article

C2 - 7305659

AN - SCOPUS:0019774490

VL - 116

SP - 1457

EP - 1460

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 11

ER -