BACKGROUND: Surgical interventions on the supra-aortic vessels are common procedures to avoid cerebral ischemia or arm pain during exercise. The safety and efficacy has been confirmed by clinical studies. Complications are rare but have serious consequences. OBJECTIVES: What special indications and recommendations are there for the diagnostics and treatment in the perioperative phase? METHODS: The current article is a literature-based review that considers international studies, guidelines and personal experiences. RESULTS: There is a broad range of complications. A simple systematic physical examination is often sufficient to give indications of the problem. Confirming clinical apparative examinations are mostly intraoperative angiography or sonography, whereas postoperative procedures include color-coded duplex sonography (FKDS) and angiography computed tomography (angio-CT). Important basic principles and aspects of operative procedures are presented. Evidence-based differences between the treatment options with resulting complications are mostly unknown; therefore, clinical management mostly relies on expert recommendations. CONCLUSION: There are several modern treatment options for invasive therapy. Despite a decrease in previous complication rates, typical perioperative complications must be considered. The diagnosis and therapy is carried out according to established strategies.
BACKGROUND: Surgical interventions on the supra-aortic vessels are common procedures to avoid cerebral ischemia or arm pain during exercise. The safety and efficacy has been confirmed by clinical studies. Complications are rare but have serious consequences. OBJECTIVES: What special indications and recommendations are there for the diagnostics and treatment in the perioperative phase? METHODS: The current article is a literature-based review that considers international studies, guidelines and personal experiences. RESULTS: There is a broad range of complications. A simple systematic physical examination is often sufficient to give indications of the problem. Confirming clinical apparative examinations are mostly intraoperative angiography or sonography, whereas postoperative procedures include color-coded duplex sonography (FKDS) and angiography computed tomography (angio-CT). Important basic principles and aspects of operative procedures are presented. Evidence-based differences between the treatment options with resulting complications are mostly unknown; therefore, clinical management mostly relies on expert recommendations. CONCLUSION: There are several modern treatment options for invasive therapy. Despite a decrease in previous complication rates, typical perioperative complications must be considered. The diagnosis and therapy is carried out according to established strategies.
Authors: J Biller; W M Feinberg; J E Castaldo; A D Whittemore; R E Harbaugh; R J Dempsey; L R Caplan; T F Kresowik; D B Matchar; J F Toole; J D Easton; H P Adams; L M Brass; R W Hobson; T G Brott; L Sternau Journal: Circulation Date: 1998-02-10 Impact factor: 29.690
Authors: Pierre Amarenco; Julien Bogousslavsky; Alfred Callahan; Larry B Goldstein; Michael Hennerici; Amy E Rudolph; Henrik Sillesen; Lisa Simunovic; Michael Szarek; K M A Welch; Justin A Zivin Journal: N Engl J Med Date: 2006-08-10 Impact factor: 91.245
Authors: R G Ackerstaff; K G Moons; C J van de Vlasakker; F L Moll; F E Vermeulen; A Algra; M P Spencer Journal: Stroke Date: 2000-08 Impact factor: 7.914
Authors: Tiziano Tallarita; Gustavo S Oderich; Giuseppe Lanzino; Harry Cloft; David Kallmes; Thomas C Bower; Audra A Duncan; Peter Gloviczki Journal: J Vasc Surg Date: 2011-01-08 Impact factor: 4.268
Authors: Helen M Colhoun; D John Betteridge; Paul N Durrington; Graham A Hitman; H Andrew W Neil; Shona J Livingstone; Margaret J Thomason; Michael I Mackness; Valentine Charlton-Menys; John H Fuller Journal: Lancet Date: 2004 Aug 21-27 Impact factor: 79.321