[Arteriosclerosis of the aortic arch branches. An analysis of 43 cases]

During 2 years and 8 months (1980.9.-1983.4), 100 patients of arteriosclerosis were admitted to our hospital. Of these patients, 43 who had clinical symptoms of TIA, RIND, or bruits on the neck or supraclavicular fossa, were reviewed. Ages ranged from 46 to 81 years (mean: 66.3). Male to female ratio was 1.9:1. Of the 43 patients, 33 were submitted to arteriography of the branches of the aortic arch. Thirty-two but one had arteriosclerotic lesions on the 62 arteries: 32 carotid, 18 vertebral, and 12 subclavian arteries, respectively. Morphologically there were 42 stenoses, 13 occlusions, 7 aneurysmal dilatations, and three other lesions. Seven patients were involved only one artery and 25 were involved more than two arteries. Eight patients were involved other regions such as lower extremities, too. Of the 43 patients, 12 were operated upon and there were no operative deaths and complications. Three of 31 who were treated conservatively, died of malignancies and heart failure. Although operative indications for TIA or RIND have been defined, those for asymptomatic lesions have not been established. Once stroke occurred, however, it would become difficult to recover from it. It is hoped that operative indications for asymptomatic lesions are established as soon as possible.