Alternatives in the Management of Atherosclerotic Occlusive Disease of Aortic Arch Branches

Robert A. Kozol, Carl E. Bredenberg

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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 (US)
Pages (from-to)1457-1460
Number of pages4
JournalArchives of Surgery
Volume116
Issue number11
DOIs
StatePublished - Nov 1981

ASJC Scopus subject areas

  • Surgery

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