Successful hybrid management of extensive thromboembolism of the innominate trunk, right subclavian artery, bilateral common carotid artery, and pulmonary embolism

Ann Vasc Surg. 2014 Aug;28(6):1566.e1-5. doi: 10.1016/j.avsg.2013.12.035. Epub 2014 Feb 11.

Abstract

Symptomatic acute carotid occlusion demands treatment, but the exact treatment to be provided in the case of acute occlusion of 3 supra-aortic vessels is not well established. Herein, we describe the successful emergency hybrid management of a massive thromboembolic occlusion of the right subclavian artery, common carotid artery, and innominate trunk, associated with left arm hemiparesis, motor aphasia, and confusion, and extensive pulmonary embolism. The diagnostic work-up and the hybrid surgical strategy adopted are described. Neurologic symptoms had completely regressed at discharge and the patient was free of any complications at the 3-month follow-up.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / surgery*
  • Brachiocephalic Trunk / diagnostic imaging
  • Brachiocephalic Trunk / physiopathology
  • Brachiocephalic Trunk / surgery*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / physiopathology
  • Carotid Artery, Common / surgery*
  • Carotid Stenosis / diagnosis
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / surgery*
  • Embolectomy*
  • Endovascular Procedures*
  • Humans
  • Male
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / physiopathology
  • Pulmonary Embolism / surgery*
  • Radiography
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / physiopathology
  • Subclavian Artery / surgery*
  • Thrombectomy*
  • Thromboembolism / diagnosis
  • Thromboembolism / physiopathology
  • Thromboembolism / surgery*
  • Treatment Outcome
  • Vascular Patency