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Aorto-innominate artery bypass for migrated stent
Jun Heng Chong1, Amer Harky2,3, Abdul Badran4
1GKT School of Medical Education, King's College London, London, UK.
Journal of Cardiac Surgery
|October 8, 2020
Summary
A patient with innominate artery stenosis experienced restenosis and stent migration. An aorto-innominate bypass successfully restored blood flow, maintaining graft patency long-term.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- Innominate artery stenosis can lead to transient ischemic attacks (TIAs).
- Endovascular stenting is a common treatment for arterial stenosis.
- Restenosis and stent migration are potential complications of endovascular procedures.
Observation:
- A 64-year-old female presented with TIA due to innominate artery stenosis, treated with a stent in 2007.
- She later developed in-stent restenosis and unusual retrograde stent migration into the ascending aortic arch.
- The patient underwent surgical intervention for the recurrent symptoms and complications.
Findings:
- An aorto-innominate bypass graft was successfully performed via median sternotomy.
- The patient experienced no complications post-surgery.
- The bypass graft demonstrated excellent patency at long-term follow-up.
Implications:
- Surgical bypass can be an effective treatment for complex innominate artery stenosis with restenosis and stent migration.
- This case highlights the importance of considering surgical options for challenging vascular complications.
- Long-term graft patency suggests the durability of surgical intervention in selected cases.
