Article Sidebar

PDF
Date Published: 29/01/2021
Online Published: 01/02/2021
Abstract Views: 341
Views PDF: 1239
DOI: https://doi.org/10.47972/vjcts.v31i.502
Issue
Vol. 31
Section
Research Article
How to Cite
Thang, D. N., Uoc, N. H., Son, N. T., Dan, N. K., Quan, P. T., Tien, L. N. ., Thach, L. D. ., Dat, N. V., & Dat, N. X. (2021). Displacement of the left vertebral artery with anatomical abnormality to left carotid artery in the thoracic aortic hybrid procedure – Indication and Technique. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 31, 47-52. https://doi.org/10.47972/vjcts.v31i.502

Displacement of the left vertebral artery with anatomical abnormality to left carotid artery in the thoracic aortic hybrid procedure – Indication and Technique

Dương Ngọc Thắng, Nguyễn Hữu Ước , Nguyễn Tùng Sơn, Nguyễn Kim Dần, Phạm Tiến Quân, Lê Nhật Tiên, Lê Đại Thạch, Nguyễn Văn Đạt, Nguyễn Xuân Đạt

Main Article Content

Abstract

Background: Bypass or displacement of the supra-aortic (carotid, subclavicular) arteries is a routine technique in hybrid surgery for complex lesions of the thoracic aorta. The vertebral artery is the first lateral branch of the left subclavicular artery, small but recommended for conservation in hybrid surgery. In the event of an anatomical abnormality - such as the left vertebral artery stemming directly from the cross of the aorta, how should it be treated. The objective of the report is to propose an indication and technique to re-establish vertebral artery circulation if having anatomic abnormality in hybrid surgery for thoracic aortic pathology. Method: The study describes three clinical cases - aortic cross injury and pathology with an abnormality of the left vertebral origin location treated with endovascular intervention and revascularization of the vertebral artery into the left carotid artery. Results: No complications related to surgery and very good circulation of the vertebral artery were observed on postoperative screening CT-scan. Conclusion: Although the indication is controversial, revascularization of the left vertebral artery into the left carotid artery is a safe and beneficial technique for patients, and can be routinely performed at Viet Duc University Hospital.

Article Details

Keywords

Hybrid, vertebral artery, aortic cross, Viet Duc

References

1. Koskas et al. (1995). Direct transposition of the distal cervical vertebral artery into the internal carotid artery. Annals of Vascular Surgery, 9(6), 515-524.
2. Lemke AJ, Benndorf G, Liebig T et al. (1999). Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery. AJNR Am J Neuroradiol, 20,1318-1321.
3. Kau T, Sinzig M, Gasser J et al. (2007). Aortic development and anomalies. Semin Intervent Radiol, 24,141-152.
4. Layton K, Kallmes DF, Cloft HJ et al. (2006). Bovine aortic arch variant in humans: clarification of a common misnomer. AJNR Am J Neuroradiol, 27,1541-1542.
5. Tapia G.P., Zhu X., Xu J. et al. (2015). Incidence of branching patterns variations of the arch in aortic dissection in Chinese patients. Medicine (Baltimore), 94,795.
6. Feezor RJ, Martin TD, Hess PJ et al. (2007). Risk factors for perioperative stroke during thoracic endovascular aortic repairs (TEVAR). J Endovasc Ther, 14,568-573.
7. Mitchell R.S., Ishimaru S., Ehrlich M.P. et al. (2002). First International Summit on Thoracic aortic endografting: roundtable on thoracic aortic dissection as an indication for endografting. J Endovasc Ther, 9,98-105.
8. Huanyu Ding, Yi Zhu, Huiyong Wang et al. (2019). Management of type B aortic dissection with an isolated left vertebral artery. Journal of vascular surgery, 70(4), 1065-1071.
9. Rizvi AZ, Murad MH, Fairman RM et al. (2009). The effect of left subclavian artery coverage on morbidity and mortality in patients undergoing endovascular thoracic aortic interventions: a systematic review and meta-analysis. J Vasc Surg, 50,1159-1169.
10. Matsumura JS, Lee WA, Mitchell RS et al. (2009). The Society for Vascular Surgery Practice Guidelines: management of the left subclavian artery with thoracic endovascular aortic repair. J Vasc Surg, 50,1155-1158.
11. Sheila N. Blumberg, Mark A. Adelman, Thomas S. Maldonado (2017). Aberrant left vertebral artery transposition and concomitant carotid-subclavian bypass for treatment of acute intramural hematoma with thoracic endovascular aortic repair. Journal of vascular surgery, 65(3), 860-864.