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Brachiocephalic aneurysm: the case for early recognition and repair
T C Bower1, P C Pairolero, J W Hallett
1Department of Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Annals of Vascular Surgery
|March 1, 1991
Summary
Surgical repair of brachiocephalic aneurysms, though rare, often presents with severe symptoms. Early, isolated surgery offers the best survival rates, while emergency or combined procedures carry higher mortality risks.
Area of Science:
- Vascular Surgery
- Aneurysm Research
- Cardiovascular Interventions
Background:
- Brachiocephalic aneurysms are uncommon, necessitating a review of surgical outcomes.
- These aneurysms can lead to life- or limb-threatening complications.
Purpose of the Study:
- To analyze surgical outcomes for brachiocephalic aneurysms over a 40-year period.
- To identify risk factors and optimal treatment strategies.
Main Methods:
- Retrospective analysis of 73 surgically treated brachiocephalic aneurysms between 1950 and 1990.
- Data collected on aneurysm type, patient demographics, presenting symptoms, etiologies, and outcomes.
Main Results:
- 40% of patients presented with stroke, ischemia, or rupture.
- Atherosclerosis was a common cause, particularly in innominate aneurysms.
- In-hospital mortality was 8.2%, with no deaths in elective isolated repairs.
Conclusions:
- Brachiocephalic aneurysms frequently present with critical complications.
- Elective, isolated surgical repair is associated with favorable long-term survival.
- Emergency or combined surgeries increase mortality risk.