[Aneurysms of the extracranial supraaortic vessels--8 years' experience]

There has been an obvious evidence of a rising incidence of the supraaortic arteries aneurysms during the last 10-15 years. It is probably the consequence of both improved diagnostics and surgical technique. MAIN PURPOSE AND STARTING POINTS (OBJECTIVES). Because of a relatively high incidence of this group of aneurysms the authors of this paper analyzed their own patients population.

From 1st Jan. 1987 to 31st Dec. 1994 10 patients were admitted 10 patients with altogether 11 supraaortic trunk aneurysms. Last year 5 patients with 5 aneurysms (45 percent) were admitted. The mean age of all patients was 57.5 (20-88) years. The mean age in the group of carotid artery aneurysms was 75.2 (71-88) years, and 31 (20-43) years in the group of subclavian artery aneurysms, respectively. Both carotid and subclavian arteries aneurysms were managed by the same technique--aneurysm resection and graft interposition. There were two exceptions. One of them was a young woman with a small asymptomatic subclavian artery aneurysm in connection with the thoracic outlet syndrome. The aneurysm has been left in its place and followed up. The second exception was a young man with a posttraumatic false aneurysm of the intrathoracic part of the right subclavian artery. He died without surgery because of massive haemorrhage due to the a false aneurysm rupture.

The hospital mortality of the group of operated patient was zero. There has been one head nerve injury in this group and 100 percent immediate patency, as well. All patients have been followed up. There have been found an asymptomatic internal carotid artery occlusion, the rest of reconstructions has been functioning.

The aneurysms of the extracranial supraaortic arteries are rare vascular lesions. They have, however, a high incidence of unfavorable sequelae, most of them of neurologic nature. The authors emphasize the importance of proper diagnosis and early surgical intervention in selected cases put into the hands of an experienced vascular surgeon. (Tab. 2, Fig. 1, Ref. 17.).