Management of cervical aortic arch complicated by multiple aneurysms

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Aortic Pathology

Background:

• Cervical aortic arch with aneurysm formation is an extremely rare condition.
• Treatment options for this pathology are limited, especially for tortuous arches unsuitable for endovascular repair.

Purpose of the Study:

• To evaluate the safety and efficacy of extra-anatomic ascending-to-infrarenal abdominal aorta bypass through the retroperitoneal cavity as an alternative treatment.
• To assess outcomes in patients with cervical aortic arch and aneurysm formation.

Main Methods:

• Retrospective review of 8 patients treated between March 2015 and April 2018.
• Comparison of endovascular repair (4 patients) versus extra-anatomic bypass (3 patients).
• Extra-anatomic bypass performed without circulatory arrest.

Main Results:

• No severe postoperative complications were observed in any patient during 6-36 months follow-up.
• Successful endovascular repairs were noted with no endoleak, migration, or stenosis.
• Extra-anatomic bypass demonstrated patent blood flow and satisfactory results, preserving the left subclavian artery in 3 patients.

Conclusions:

• Extra-anatomic ascending-to-infrarenal abdominal aorta bypass is a safe and effective treatment for cervical aortic arch with tortuous aorta, aneurysm, and coarctation.
• This approach provides a valuable alternative for patients unsuitable for endovascular repair.