Milos Sladojevic1, Miroslav Markovic2, Nikola Ilic2, Sinisa Pejkic2, Igor Banzic2, Predrag Djoric2, Igor Koncar2, Ivan Tomic3, Lazar Davidovic2. 1. Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: milos.sladojevic@gmail.com. 2. Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 3. Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND: Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases. CASE REPORTS: We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment. CONCLUSIONS: When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible.
BACKGROUND: Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases. CASE REPORTS: We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment. CONCLUSIONS: When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible.
Authors: Josh A Sibille; Joel P Harding; Jocelyn K Ballast; Mohammad Hooshmand; Jeko M Madjarov; Frank R Arko Journal: J Vasc Surg Cases Innov Tech Date: 2016-12-24