A braciocephalic aneurysm repaired with hybrid operation

Duy Tan Nguyen1, Ngoc Hanh Huynh1,
1 Thong Nhat Hospital

Main Article Content

Abstract

Purpose: Aneurysm of arteries branching from the aortic arch such as the subclavian artery, brachiocephalic artery, common carotid artery, internal and external carotid artery, cervical part of the vertebral artery is an uncommon condition.. Hemorrhage shock and death could result from rupture of the aneurysm into the lung, pleural space, esophagus and the trachea. Treatment of supra-aortic aneurysms may be tricky and there is no standard treatment for these aneurysms. Open surgery imposes high mortality rate, while endovascular treatment alone may not eradicate all the lesion in case of infectious aneurysm.


Methods:  We report a case of rupture of infectious brachiocephalic aneurysm.


Result: Hybrid operation was performed with carotd- carotid bypass and brachiocephacic artery stentgraft placement

Article Details

References

[1] Marcelo Cury, Roy K. Greenberg, Jose P. Morales, Walid Mohabbat, Adrian V. Hernandez. Supra-aortic vessels aneurysms: Diagnosis and prompt intervention. Journal of Vascular Surgery 2009;49(1): 4-10
[2] Regina G, Greco L, Testini M, Todisco C, Iusco D, Rizzi R. Treatment of supra-aortic trunk aneurysms: report on 16 cases. Chir Ital 1999;51: 139-44
[3] Lian LS, Zhang Z, Feng H, Chen XM. Hybrid surgery for a severe infectious innominate artery pseudoaneurysm compressing the main trachea. J Int Med Res. 2020;48(10):300060520965843.
[4] Wang XL, Guan XL, Jiang WJ, Liu O, Zhang HJ. Innominate artery aneurysm, how to solve it?. J Int Med Res. 2017;45(3):1279-1284.
[5] Kieffer E, Chiche L, Koskas F, et al. Aneurysms of the innominate artery: surgical treatment of 27 patients, J Vasc Surg 2001; 34: 222–228.
[6] Kraus TW, Paetz B, Richter GM, et al. The isolated posttraumatic aneurysm of the brachiocephalic artery after blunt thoracic contusion. Ann Vasc Surg 1993; 7: 275–281.
[7] Maeda H, Umezawa H, Goshima M, Hattori T, Nakamura T, Umeda T, Shiono M. Primary infected abdominal aortic aneurysm: surgical procedures, early mortality rates, and a survey of the prevalence of infectious organisms over a 30-year period. Surg Today. 2011 Mar;41(3):346-51
[8] Huang YK, Chen CL, Lu MS, Tsai FC, Lin PL, Wu CH, Chiu CH. Clinical, microbiologic, and outcome analysis of mycotic aortic aneurysm: the role of endovascular repair. Surg Infect (Larchmt). 2014 Jun;15(3):290-8
[9] Pruitt A, Dodson TF, Najibi S, Thourani V, Sherman A, Cloft H, Caliendo A, Smith RB 3rd. Distal septic emboli and fatal brachiocephalic artery mycotic pseudoaneurysm as a complication of stenting. J Vasc Surg. 2002 Sep;36(3):625-8.
[10] Bunt TJ, Gill HK, Smith DC, Taylor FC. Infection of a chronically implanted iliac artery stent. Ann Vasc Surg 1997;11:529-32.
[11] Myles O, Thomas WJ, Daniels JT, Aronson N. Infected endovascular stents managed with medical therapy alone. Cathet Cardiovasc Intervent 2000;51:471-6.
[12] Stefańczyk L, Elgalal M, Ustyniak S, Polguj M, Majos A. Arterio-bronchial fistula as a complication of post-traumatic subclavian artery pseudoaneurysm - radiological findings and outcome. Adv Respir Med. 2019;87(2):110-113.
[13] Khalil A, Parrot A, Nedelcu C, et al. Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography. Chest. 2008; 133(1): 212–219