scholarly journals Emergency Operation for an Unconscious Patient Caused by Stanford Type A Acute Aortic Dissection with Occlusion of the Right Common Carotid Artery

2012 ◽  
Vol 41 (3) ◽  
pp. 124-127
Author(s):  
Hideaki Yamabi ◽  
Kazuhito Imanaka ◽  
Takahiro Matsuoka ◽  
Mitsuhiro Kawata
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Common Carotid Artery ◽  
Acute Aortic Dissection ◽  
Emergency Operation ◽  
Type A ◽  
Unconscious Patient ◽  
The Right

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

Prior reconstruction of an isolated left vertebral artery for Stanford type A aortic dissection

2020 ◽  
Author(s):  
Yi Zuo ◽  
Zheng-Chun Zhou ◽  
Jian-Jun Ge
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Vertebral Artery ◽  
Common Carotid Artery ◽  
Type A ◽  
Left Common Carotid Artery ◽  
Total Arch Replacement ◽  
Left Vertebral Artery ◽  
Elephant Trunk ◽  
Type A Aortic Dissection

Abstract Although isolated left vertebral artery is a supra-aortic trunk variant, it is not so rare. It may pose additional difficulties during total arch replacement surgeries. The aim of this study was to present our experience with prior reconstruction of isolated left vertebral artery by isolated left vertebral artery–left common carotid artery during total arch replacement combined with stented elephant trunk implantation.

scholarly journals Two different cases of postoperative symptomatic common carotid artery involvment in type A aortic dissection

2012 ◽  
Vol 2012 (nov22 2) ◽  
pp. bcr2012006902-bcr2012006902 ◽  
Author(s):  
R. A. Droeser ◽  
T. Wolff ◽  
E. Mujagic ◽  
L. Gurke
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Common Carotid Artery ◽  
Type A ◽  
Type A Aortic Dissection

scholarly journals Aorto-Cutaneous Fistula and False Aneurysm of the Ascending Aorta Five Years after its Prosthetic Replacement for Stanford Type A Acute Aortic Dissection

Aorta ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 57-60
Author(s):  
Pierre Demondion ◽  
Dorian Verscheure ◽  
Pascal Leprince
Keyword(s):  
Aortic Dissection ◽  
Carotid Arteries ◽  
Acute Aortic Dissection ◽  
False Aneurysm ◽  
Type A ◽  
Aneurysm Rupture ◽  
Ascending Aorta ◽  
Cutaneous Fistula ◽  
The Right ◽  
Selective Cannulation

AbstractAorto-cutaneous fistula and false aneurysm of the ascending aorta in patients who previously underwent Stanford Type A acute aortic dissection are rare and severe complications. Surgical correction remains a demanding challenge. In a case of false aneurysm rupture during redo sternotomy, selective cannulation of the right axillary and left carotid arteries allowed an efficient method of cerebral perfusion.

Common carotid artery true lumen flow impairment in patients with type A aortic dissection

2020 ◽  
Author(s):  
Maximilian Kreibich ◽  
Nimesh D Desai ◽  
Joseph E Bavaria ◽  
Wilson Y Szeto ◽  
Prashanth Vallabhajosyula ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Common Carotid Artery ◽  
Type A ◽  
Acute Type ◽  
Imaging Data ◽  
True Lumen ◽  
Type A Aortic Dissection ◽  
Logistic Regression Models

Abstract OBJECTIVES Our aim was to evaluate clinical and neurological effects of common carotid artery (CCA) true lumen flow impairment or occlusion in patients with type A aortic dissection. METHODS Characteristics and imaging data of patients with dissected CCA secondary to acute type A aortic dissection from 3 institutions were analysed. We defined true lumen blood flow as unimpaired when the maximum true lumen diameter exceeded 50% of the complete CCA diameter, as impaired when the true lumen was compressed to ˃50% of the complete lumen, or as occluded. RESULTS Out of 440 patients, 207 presented unimpaired CCA flow, 172 impaired CCA flow and CCA occlusion was present in 61 patients. Preoperative shock (P = 0.045) or a neurological deficit (P < 0.001) were least common in patients with unimpaired CCA flow and most common in those with CCA occlusion. Non-cerebral, other-organ malperfusion was common in 37% of all patients, but the incidence was similar (P = 0.69). In patients with CCA occlusion, postoperative stroke (P < 0.001) and in-hospital mortality (0.011) were significantly higher, while the incidences were similar between patients with unimpaired and impaired CCA flow. Mixed-effects logistic regression models showed that CCA flow impairment (P = 0.23) or occlusion (P = 0.55) was not predictive for in-hospital mortality, but CCA occlusion was predictive for in-hospital stroke (odds ratio 2.166, P = 0.023) CONCLUSIONS Shock and non-cerebral, other-organ malperfusion are common in patients with CCA dissection. While there is a high risk for stroke in patients with CCA occlusion, CCA flow impairment and occlusion were not predictive for in-hospital mortality. Surgery should not be denied to patients with CCA flow impairment or occlusion.

Incidence and risk factors of recurrent pain in acute aortic dissection and in-hospital mortality

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 301-310
Author(s):  
Dilixiati Siti ◽  
Asiya Abudesimu ◽  
Xiaojie Ma ◽  
Lei Yang ◽  
Xiang Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Acute Aortic Dissection ◽  
Emergency Operation ◽  
Type A ◽  
Type B ◽  
Recurrent Pain ◽  
Group I ◽  
Group Ii

Abstract. Background: We investigated the prevalence of recurrent pain and its relationship with in-hospital mortality in acute aortic dissection (AAD). Patients and methods: Between 2011 and 2016, 234 AAD patients were selected. Recurrent pain was defined as a mean of VAS > 3, within 48 hours following hospital admission or before emergency operation. Patients with and without recurrent pain were divided into group I and group II, respectively into type A AAD and type B AAD patients. Our primary outcome was in-hospital mortality. Results: The incidence of recurrent pain was 24.4 % in AAD patients. Incidence of recurrent pain was higher in type A AAD patients than type B AAD patients (48.9 vs. 9.6 %). Overall in-hospital mortality was 25.6 %. Type A AAD had a higher in-hospital mortality than type B AAD patients (47.7 vs. 12.3 %). Group I had significantly higher in-hospital mortality than group II (type A: 79.1 vs. 17.8 %; type B: 57.1 vs. 7.6 %, all P < 0.001), as was the case with medical managed patients (type A: 72.1 vs. 13.3 %; type B: 35.7 vs. 2.3 %, all P < 0.001). Logistic regression analysis showed that use of one drug alone and waist pain were predictive factors for recurrent pain in type A AAD and type A AAD patients, respectively (OR 3.686, 95 % CI: 1.103~12.316, P = 0.034 and OR 14.010, 95 % CI: 2.481~79.103, P = 0.003). Recurrent pains were the risk factors (type A: OR 11.096, 95 % CI: 3.057~40.280, P < 0.001; type B: OR 14.412, 95 % CI: 3.662~56.723, P < 0.001), while invasive interventions were protective (type A: OR 0.133, 95 % CI: 0.035~0.507, P < 0.001; type B: OR 0.334, 95 % CI: 0.120~0.929, P = 0.036) for in-hospital mortality in AAD patients. Conclusions: Approximately one-fourth of AAD patients presented with recurrent pains, which might increase in-hospital mortality. Thus, interventional strategies at early stages are important.

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