Del Valle CE, Ferreira LFT, Bragato PH, Oliveira SLD, Mauro FDO, Araújo WJBD. Inversão total do fluxo em artéria carótida interna direita em paciente com estenose grave do tronco braquiocefálico.
J Vasc Bras 2020;
19:e20190124. [PMID:
34178067 PMCID:
PMC8202210 DOI:
10.1590/1677-5449.190124]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Occlusions and severe stenoses of the innominate artery (brachiocephalic trunk) are
rare and present with a wide variety of clinical manifestations, with hemispheric,
vertebrobasilar and right upper limb ischemic symptoms. The most common cause is
atherosclerosis. Duplex scanning may show right vertebral artery flow reversal,
diminished subclavian flow, and several patterns of right carotid flow disturbance,
including slow flow, partial flow reversal during the cardiac cycle and even complete
reversal of flow in the internal carotid artery, which is a very uncommon finding.
Herein, the authors describe the case of a female patient who was a heavy smoker, had
severe stenosis of the brachiocephalic trunk, and had episodes of collapse. Besides
the subclavian steal and partial flow reversal in the common carotid artery, duplex
scanning also showed high-velocity reversed flow in the internal carotid artery
during the entire cardiac cycle, a finding that is not reported in the literature at
this magnitude.
Collapse