Aortic arch vessel stenting: A single-center experience using cerebral protection

Brian G. Peterson, Scott A. Resnick, Mark D. Morasch, Heitham T Hassoun, Mark K. Eskandari

Research output: Contribution to journalArticle

Abstract

Hypothesis: Endovascular interventions have revolutionized the contemporary treatment of peripheral vascular occlusive disease. Traditional management of supra-aortic trunk disease has employed surgical extra-anatomic bypass via a cervical approach or median sternotomy. Endoluminal therapy may be a less morbid alternative. Design and Setting: A retrospective review of procedures performed by vascular surgeons in an operating room angiosuite at a single university-based, tertiary referral center. Patients: Eighteen consecutive patients with 20 brachiocephalic-origin stenoses. Interventions: From December 2001 through September 2005, 20 brachiocephalic-origin stenoses were treated endoluminally with balloon-expandable stents. Treated vessels were innominate (n=8), common carotid (n=9), and subclavian (n=3). The target lesion was accessed by one of the following methods: antegrade via the femoral artery (n=5), retrograde through the brachial artery (n=1), or via a retrograde cut-down on the common carotid artery (n=14). Cerebral protection was achieved with either a distal embolic filter device or with open surgical occlusion of the distal common carotid artery. Main Outcome Measures: We report immediate and midterm outcomes of all aortic arch vessel stenting procedures with mean follow-up of 12 months. Results: Mean age was 68 years (6 men and 12 women) and overall mean stenosis was 85%. Preprocedural symptoms including stroke, transient ischemic attack, arm fatigue, digital ischemia, and angina were present in 16 of 20 cases (80%). The 4 asymptomatic patients all had more than 90% stenosis on angiography. At 30-day follow-up, there were no deaths, myocardial infarctions, or strokes. During follow-up, there were no cases of restenosis. Conclusion: Endoluminal arterial stenting of brachiocephalic arch vessels may be a viable alternative to traditional open bypass in cases of focal stenotic disease.

Original languageEnglish (US)
Pages (from-to)560-563
Number of pages4
JournalArchives of Surgery
Volume141
Issue number6
DOIs
StatePublished - 2006
Externally publishedYes

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Thoracic Aorta
Pathologic Constriction
Common Carotid Artery
Stroke
Aortic Diseases
Sternotomy
Brachial Artery
Peripheral Vascular Diseases
Transient Ischemic Attack
Femoral Artery
Operating Rooms
Tertiary Care Centers
Stents
Fatigue
Blood Vessels
Angiography
Ischemia
Myocardial Infarction
Outcome Assessment (Health Care)
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery

Cite this

Peterson, B. G., Resnick, S. A., Morasch, M. D., Hassoun, H. T., & Eskandari, M. K. (2006). Aortic arch vessel stenting: A single-center experience using cerebral protection. Archives of Surgery, 141(6), 560-563. https://doi.org/10.1001/archsurg.141.6.560

Aortic arch vessel stenting : A single-center experience using cerebral protection. / Peterson, Brian G.; Resnick, Scott A.; Morasch, Mark D.; Hassoun, Heitham T; Eskandari, Mark K.

In: Archives of Surgery, Vol. 141, No. 6, 2006, p. 560-563.

Research output: Contribution to journalArticle

Peterson, BG, Resnick, SA, Morasch, MD, Hassoun, HT & Eskandari, MK 2006, 'Aortic arch vessel stenting: A single-center experience using cerebral protection', Archives of Surgery, vol. 141, no. 6, pp. 560-563. https://doi.org/10.1001/archsurg.141.6.560
Peterson, Brian G. ; Resnick, Scott A. ; Morasch, Mark D. ; Hassoun, Heitham T ; Eskandari, Mark K. / Aortic arch vessel stenting : A single-center experience using cerebral protection. In: Archives of Surgery. 2006 ; Vol. 141, No. 6. pp. 560-563.
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