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Oliveira VC, Coutinho G, Fonseca M, Antunes LF. Innominate artery post-traumatic pseudoaneurysm presenting with Horner's syndrome. Interact Cardiovasc Thorac Surg 2021; 33:829-831. [PMID: 34027554 DOI: 10.1093/icvts/ivab156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/27/2021] [Accepted: 04/26/2021] [Indexed: 11/14/2022] Open
Abstract
Isolated innominate artery trauma after blunt thoracic contusion is rare and occurs mostly at its origin. We report a case of a post-traumatic distal innominate artery pseudoaneurysm presenting with Horner's syndrome treated by conventional surgical approach.
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Affiliation(s)
- Vânia Constâncio Oliveira
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Gonçalo Coutinho
- Department of Cardiothoracic Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Manuel Fonseca
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Luis F Antunes
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Deshpande AA, Agasty S, Kumar S, Ramakrishnan P. Isolated traumatic innominate artery dissection: an exceedingly rare entity! BMJ Case Rep 2021; 14:e241710. [PMID: 33649033 PMCID: PMC7929854 DOI: 10.1136/bcr-2021-241710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Amit Ajit Deshpande
- Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Agasty
- Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar
- Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Ramakrishnan
- Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
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Pereira-Neves A, Gouveia R, Dias-Neto M, Duarte-Gamas L, Rocha-Neves J, Teixeira J. Covered Endovascular Repair of Innominate Artery Bifurcation After Thoracic Blunt Trauma. Vasc Endovascular Surg 2020; 55:405-409. [PMID: 33252013 DOI: 10.1177/1538574420976478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Innominate artery (IA) injury is a rare entity with most patients dying before reaching the hospital. While open surgery remains the standard treatment, the endovascular approach is attractive as it may reduce perioperative morbidity and mortality. We report a case of IA blunt injury extending to the subclavian artery with pseudoaneurysm formation successfully treated with covered stenting of IA and its bifurcation. A 49-year-old male was admitted after suffering multiple trauma due to a high energy impact motorcycle crash. In the emergency room, the patient was hypotensive with a Glasgow coma score of 15. On physical examination, he had right peri-orbital ecchymosis, left otorrhagia and an open patella fracture. The computed tomographic angiography (CTA) revealed enlargement of the mediastinum and a 29 mm pseudoaneurysm involving the right brachiocephalic trunk and its bifurcation. Under general anesthesia, a covered balloon-expandable stent (CBES) was then placed in the IA followed by kissing stent of its bifurcation with an additional 2 covered balloon-expandable stents. Final subtraction angiography demonstrated complete pseudoaneurysm exclusion and stent patency without additional complications. No neurologic deficits or other intervention-related complications were found in the postoperative period. At 10 months follow-up, the patient remained asymptomatic and with palpable distal pulses. Endovascular management of IA injury may provide a good alternative to open surgery with low perioperative morbidity and mortality.
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Affiliation(s)
- António Pereira-Neves
- Department of Biomedicine-Unit of Anatomy, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Surgery and Physiology, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Angiology and Vascular Surgery, 26706Centro Hospitalar Universitário São João, EPE, Porto, Portugal
| | - Ricardo Gouveia
- Department of Surgery and Physiology, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Angiology and Vascular Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marina Dias-Neto
- Department of Surgery and Physiology, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Angiology and Vascular Surgery, 26706Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Cardiovascular R&D Unit, 26705Faculdade de Medicina da Universidade Do Porto, Portugal
| | - Luís Duarte-Gamas
- Department of Surgery and Physiology, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Angiology and Vascular Surgery, 26706Centro Hospitalar Universitário São João, EPE, Porto, Portugal
| | - João Rocha-Neves
- Department of Biomedicine-Unit of Anatomy, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Surgery and Physiology, 26705Faculty of Medicine, University of Porto, Portugal.,Department of Angiology and Vascular Surgery, 26706Centro Hospitalar Universitário São João, EPE, Porto, Portugal
| | - José Teixeira
- Department of Angiology and Vascular Surgery, 26706Centro Hospitalar Universitário São João, EPE, Porto, Portugal
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Ahmad M, Asghar M, Divecha C, Swain TW. A Complicated Case of Innominate Artery Avulsion and Subsequent Aorto-subclavian Graft Occlusion. Cureus 2019; 11:e5056. [PMID: 31293843 PMCID: PMC6605967 DOI: 10.7759/cureus.5056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 41-year-old female presented with complaints of right arm claudication, weakness, and pain associated with serous drainage from a previous incision site to the right anterior chest. At age 16, this patient was involved in a motor vehicle accident, which resulted in a right innominate artery and brachiocephalic vein avulsion. The two vessels were immediately ligated and oversewn. The perfusion to her right arm was supplied by cerebral collateral circulation down the right vertebral to the right subclavian artery.
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Affiliation(s)
- Mansoor Ahmad
- Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, USA
| | - Muhammad Asghar
- Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, USA
| | - Chirag Divecha
- Cardiology, University of Illinois College of Medicine at Peoria, Peoria, USA
| | - Timothy W Swain
- Cardiac Surgery, University of Illinois College of Medicine at Peoria, Peoria, USA
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