Infarto cerebral provocado por la compresión inducida por la deglución de una arteria subclavia derecha aberrante
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Updated: Sep 10, 2025
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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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Yuya Kobayashi1, Ken-Ichi Kobayashi1, Chinami Yuazawa1
1Department of Neurology, Ina Central hospital, Japan.
Internal medicine (Tokyo, Japan)
|August 27, 2025
Resumen
Los accidentes cerebrovasculares recurrentes en un hombre de edad avanzada se relacionaron con una arteria subclavia derecha aberrante comprimida (ARSA). La deglución desencadenó estos eventos debido a la compresión mecánica. La colocación de un stent resolvió el problema y evitó nuevos infartos cerebrales.
Área de la Ciencia:
- Cirugía vascular
- Neurología
- Cardiología
Sus antecedentes:
- Pueden ocurrir infartos cerebrales recurrentes a pesar de la doble terapia antiplaquetaria.
- La arteria subclavia derecha aberrante (ARSA) es una anomalía congénita rara.
- La compresión mecánica de un ARSA estenótico por la deglución es una causa potencial de eventos isquémicos.
Objetivo del estudio:
- Para investigar la causa de los infartos cerebrales recurrentes en un paciente con una arteria subclavia derecha anormal.
- Para describir el mecanismo del accidente cerebrovascular provocado por la deglución en este caso específico.
- Evaluar la eficacia de la colocación de stents endovasculares para el tratamiento de los infartos cerebrales inducidos por ARSA.
Principales métodos:
- Presentación en pacientes con infartos cerebrales recurrentes.
- Las imágenes de diagnóstico revelan una arteria estenótica, calcificada y aberrante de la subclavia derecha.
- Estentamiento endovascular de la arteria subclavia derecha aberrante y la arteria subclavia izquierda.
Principales resultados:
- El paciente experimentó infartos cerebrales recurrentes, particularmente provocados por la deglución.
- Las imágenes confirmaron una arteria estenótica, calcificada y aberrante adyacente al esófago.
- Se realizó con éxito el stenting de la ARSA y de la arteria subclavia izquierda.
Conclusiones:
- La compresión mecánica de un ARSA estenótico durante la deglución puede causar infartos cerebrales recurrentes.
- La colocación de stents endovasculares es un tratamiento eficaz para la isquemia cerebral relacionada con el ARSA.
- Este caso pone de relieve la importancia de considerar las anomalías vasculares en los accidentes cerebrovasculares criptogénicos.
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