Avtor/Urednik		Reul, George J; Jacobs, Michael J; Gregorič, Igor D; Calderon, Moises; Duncan, J Michael; Ott, David A; Livesay, James J; Cooley, Denton A
Naslov		Innominate artery occlusive disease: surgical approach and long-term results
Tip		članek
Vir		J Vasc Surg
Vol. in št.		Letnik 14, št. 3
Leto izdaje		1991
Obseg		str. 405-12
Jezik		eng
Abstrakt		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.
Deskriptorji		ADULT AGED AORTA ARTERIAL OCCLUSIVE DISEASES BLOOD VESSEL PROSTHESIS BRACHIOCEPHALIC TRUNK CONSTRICTION, PATHOLOGIC ENDARTERECTOMY GRAFT OCCLUSION, VASCULAR POLYETHYLENE TEREPHTHALATES POLYTETRAFLUOROETHYLENE POSTOPERATIVE COMPLICATIONS PROGNOSIS SURVIVAL RATE