Surgical treatment of great vessel occlusive disease

Occlusive disease of the supra-aortic trunks remains a diagnostic and therapeutic challenge to the surgeon. Although most cases in Western series are attributable to atherosclerotic disease, other entities such as Takayasu arteritis and radiation arteritis account for a substantial subset of patients in whom choice of therapy and clinical response may be significantly affected by the peculiarities of the disease process involved. This article reviews the anatomy, causes, and diagnosis of occlusive disease of the supra-aortic trunks. The indications, techniques, and outcomes of reconstruction are also discussed.