Management of aortic arch and brachiocephalic atherosclerotic disease

Scott Stevens, Gregorio A. Sicard

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Usually nonulcerative and asymptomatic, atherosclerotic disease in the brachiocephalic system infrequently requires operative intervention. Typically, multilevel disease is required to produce ischemic symptoms and even these lesions rarely pose a risk for tissue loss or stroke. Usually, only severe symptoms of hypoperfusion require operative intervention. Infrequently, embologenic lesions require prompt surgical therapy to avert tissue loss or stroke. In older, physiologically compromised patients, extrathoracic procedures should be used whenever possible to minimize the incidence of perioperative morbidity and mortality. Transthoracic reconstructions provide superior cosmesis and patency and should be considered in young patients. Occasionally, multiple arch lesions thwart extrathoracic repair and require a transthoracic approach for inflow off the ascending aorta. Advances in perioperative patient care and monitoring have substantially decreased the risk of both transthoracic and extrathoracic brachiocephalic reconstructions; however, familiarity with anatomy and technical skill remain prerequisite to successful repair. When patients are precisely diagnosed and carefully selected, and their treatments meticulously executed, surgical therapy for brachiocephalic disease can be particularly durable and successful.

Original languageEnglish (US)
Pages (from-to)113-122
Number of pages10
JournalSeminars in Vascular Surgery
Volume4
Issue number3
StatePublished - Jan 1 1991

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Thoracic Aorta
Stroke
Perioperative Care
Asymptomatic Diseases
Physiologic Monitoring
Aorta
Anatomy
Patient Care
Therapeutics
Morbidity
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Management of aortic arch and brachiocephalic atherosclerotic disease. / Stevens, Scott; Sicard, Gregorio A.

In: Seminars in Vascular Surgery, Vol. 4, No. 3, 01.01.1991, p. 113-122.

Research output: Contribution to journalArticle

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