Evaluation of the Vertebrobasilar System in Thoracic Aortic Surgery

Sugiura, T.; Imoto, Kiyotaka; Uchida, Keiji; Yanagi, Hiromasa; Machida, Daisuke; Okiyama, Makoto; Yasuda, Shota; Manaka, Hiroshi

doi:10.1016/j.athoracsur.2011.04.031

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…In cases of left VA dominance, revascularization of the left SCA should be performed to maintain blood flow to the brain stem area; however, it would usually not be required in cases of right VA dominance. 5,6) Termination of the left VA in the PICA is also an important anatomical abnormality that may require revascularization of the left SCA. 4,10) In patients who exhibit a PICA end pattern, even though the left VA is hypoplastic (right dominance), the blood flow in the PICA is only supplied by the left VA.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular Repair of an Aortic Arch Aneurysm in a Patient with a Hypoplastic Left Vertebral Artery Terminating into the Posterior Inferior Cerebellar Artery

Sato

Emura

Tomiyoshi

et al. 2019

Annals of Vascular Diseases

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We present a 76-year-old male with an aortic arch aneurysm and a hypoplastic left vertebral artery (VA). Endovascular repair with left subclavian artery (SCA) closure was planned. The right VA was dominant, while the left VA was hypoplastic, barely connected to the basilar artery, and appeared to terminate at the posterior inferior cerebellar artery (PICA). The VA sizes and flow patterns during ultrasonography confirmed these findings. Therefore, we performed endovascular repair with left SCA reconstruction to prevent ischemia of the PICA perfusion area. After the operation, he experienced no difficulty with brain perfusion.

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Section: Discussionmentioning

confidence: 99%

“…3,4) However, the VAs exhibit anatomical variations in many cases. 5,6) Therefore, VA anatomy must be evaluated by preoperative diagnostic imaging. In the present case, we evaluated the anatomy of the cerebral vessels in detail using ultrasonography 7) in addition to computed tomography (CT) and magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

Endovascular Repair of an Aortic Arch Aneurysm in a Patient with a Hypoplastic Left Vertebral Artery Terminating into the Posterior Inferior Cerebellar Artery

Sato

Emura

Tomiyoshi

et al. 2019

Annals of Vascular Diseases

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“…No paraplegia was observed, but one stroke occurred postoperatively due to interruption of the left posterior inferior cerebellar artery (PICA). Although stroke developed in the patient who underwent covering of the LSA with a stent graft without revascularization, the association between PICA-related stroke and simple occlusion of the LSA is not clear [ 14 ]. In practice, it is not easy to routinely revascularize the LSA when emergency or urgent TEVAR is required for life-threatening rDTAA.…”

Section: Discussionmentioning

confidence: 99%

Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

Choi

Sung

et al. 2016

Korean J Thorac Cardiovasc Surg

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BackgroundThe aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition.MethodsAmong 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA.ResultsThe mean age was 72.4±5.1 years, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was 269.8±72.3 minutes. The mean total length of aortic coverage was 186.0±49.2 mm. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of 16.8±14.8 months, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown.ConclusionTEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

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“…We consider it important to classify vertebral artery variations. Patients with an interrupted right vertebral artery or left terminal posterior inferior cerebellar artery are at high risk of cerebellar infarction following simple occlusion of the left subclavian artery . In patients requiring urgent TEVAR for rDTAA where achievement of a proximal seal necessitates coverage of the left subclavian artery and possessing an interrupted right vertebral artery or left terminal posterior inferior cerebellar artery, we performed bypass to the left subclavian artery before TEVAR.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Endovascular Aortic Repair for Ruptured Descending Thoracic Aortic Aneurysm

et al. 2014

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Evaluation of the Vertebrobasilar System in Thoracic Aortic Surgery

Cited by 10 publications

References 13 publications

Endovascular Repair of an Aortic Arch Aneurysm in a Patient with a Hypoplastic Left Vertebral Artery Terminating into the Posterior Inferior Cerebellar Artery

Endovascular Repair of an Aortic Arch Aneurysm in a Patient with a Hypoplastic Left Vertebral Artery Terminating into the Posterior Inferior Cerebellar Artery

Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

Thoracic Endovascular Aortic Repair for Ruptured Descending Thoracic Aortic Aneurysm

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