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Related Experiment Videos

Innominate artery lesions: problems encountered and lessons learned.

D C Brewster, A C Moncure, R C Darling

    Journal of Vascular Surgery
    |January 1, 1985
    PubMed
    Summary

    Innominate artery lesions are rare but complex. Direct surgical repair, particularly for occlusive disease, offers the best long-term outcomes with acceptable mortality.

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    Area of Science:

    • Vascular Surgery
    • Thoracic Surgery
    • Cardiovascular Medicine

    Background:

    • Innominate artery lesions, though uncommon, pose significant surgical challenges.
    • A comprehensive review of diverse innominate artery pathologies and their management is crucial for clinical practice.

    Purpose of the Study:

    • To classify the spectrum of innominate artery problems requiring surgical intervention.
    • To elucidate key principles in the management of these complex vascular conditions.

    Main Methods:

    • Retrospective review of 71 patients undergoing surgery for innominate artery issues over a 20-year period.
    • Analysis of lesion types, operative procedures, and patient outcomes.

    Main Results:

    • Occlusive disease was the most frequent lesion (37 patients), often presenting with neurological or ocular symptoms.

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  • Other pathologies included aneurysms, dissections, trauma, tracheoinnominate fistulas, anomalous origins, and mediastinal involvements.
  • Transsternal repair yielded the best long-term results for occlusive disease with a 3.4% mortality rate; extrathoracic grafting was less durable.

    • Conclusions:

    • Direct surgical repair, especially via median sternotomy for occlusive innominate artery disease, provides superior long-term results.
    • Management strategies and outcomes vary significantly based on the specific nature of the innominate artery lesion.