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Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2013

Open Access 01-12-2013 | Case report

Surgical treatment of innominate artery and aortic aneurysm: a case report and review of the literature

Authors: Erdinc Soylu, Leanne Harling, Hutan Ashrafian, Vania Anagnostakou, Dimitris Tassopoulos, Christos Charitos, John Kokotsakis, Thanos Athanasiou

Published in: Journal of Cardiothoracic Surgery | Issue 1/2013

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Abstract

Innominate artery (IA) aneurysms represent 3% of all arterial aneurysms. Due to the risk of thromboembolic complications and spontaneous rupture, surgical repair is usually recommended on an early elective basis. We present the case of 81-year-old Caucasian male presenting with atypical anterior chest pain secondary to a large innominate artery aneurysm who underwent successful open surgical repair at our institution. In our experience, open correction via median sternotomy with extension into the right neck provides excellent exposure and facilitates rapid reconstruction with good short and long-term outcomes. Minimally invasive and endovascular approaches provide emerging alternatives to open IA aneurysm repair, however further research is required to better define optimal patient selection criteria and determine the long-term outcomes of these novel therapies.
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Literature
1.
Stolf NA, Bittencourt D, Verginelli G, Zerbini EJ: Surgical treatment of ruptured aneurysms of the innominate artery. Ann Thorac Surg. 1983, 35 (4): 394-399. 10.1016/S0003-4975(10)61591-3.CrossRefPubMed
2.
Cury M, Greenberg RK, Morales JP, Mohabbat W, Hernandez AV: Supra-aortic vessels aneurysms: diagnosis and prompt intervention. J Vasc Surg. 2009, 49 (1): 4-10. 10.1016/j.jvs.2008.08.088.CrossRefPubMed
3.
Bower TC, Pairolero PC, Hallett JW, Toomey BJ, Gloviczki P, Cherry KJ: Brachiocephalic aneurysm: the case for early recognition and repair. Ann Vasc Surg. 1991, 5 (2): 125-132. 10.1007/BF02016744.CrossRefPubMed
4.
Cherry K: Treatment of extracranial, carotid, innominate, subclavian and axillary aneurysms. Mastery of vascular and endovascular surgery: An illustrated review. Edited by: Zelenock GB, Huber TS, Messina LM, Lumsden AB, Moneta GL. 2006, Philadelphia, Pa: Lippincott, Williams & Wilkins, 79-84.
5.
Kieffer E, Chiche L, Koskas F, Bahnini A: Aneurysms of the innominate artery: surgical treatment of 27 patients. J Vasc Surg. 2001, 34 (2): 222-228. 10.1067/mva.2001.115807.CrossRefPubMed
6.
Kraus TW, Paetz B, Richter GM, Allenberg JR: The isolated posttraumatic aneurysm of the brachiocephalic artery after blunt thoracic contusion. Ann Vasc Surg. 1993, 7 (3): 275-281. 10.1007/BF02000254.CrossRefPubMed
7.
Angiletta D, Marinazzo D, Guido G, Fullone M, Pulli R, Regina G: Eight-year follow-up of endovascular repair of a brachiocephalic trunk aneurysm due to Takayasu's arteritis. J Vasc Surg. 2012, 56 (2): 504-507. 10.1016/j.jvs.2012.02.031.CrossRefPubMed
8.
Taha MM, Nakahara I, Higashi T, Iwamuro Y, Watanabe Y, Taki W: Interventional neuroradiological techniques for the treatment of aneurysms of the supra-aortic extracranial arteries. Neurol Med Chir. 2010, 50 (4): 275-280. 10.2176/nmc.50.275.CrossRef
9.
Puech-Leão P, Orra HA: Endovascular repair of an innominate artery true aneurysm. J Endovasc Ther. 2001, 8 (4): 429-432. 10.1583/1545-1550(2001)008<0429:EROAIA>2.0.CO;2.CrossRefPubMed
10.
Park JH, Chung JW, Joh JH, Song SY, Shin SJ: Aortic and arterial aneurysms in behçet disease: management with stent-grafts- initial experience. Radiology. 2001, 220: 745-750. 10.1148/radiol.2203001418.CrossRefPubMed
11.
Melissano G, Civilini E, Marrocco-Trischitta MM, Chiesa R: Hybrid endovascular and off-pump open surgical treatment for synchronous aneurysms of the aortic arch, brachiocephalictrunk, and abdominal aorta. Tex Hear Inst J. 2004, 31 (3): 283-287.
12.
Takach TJ, Lalka SG: Innominate artery aneurysm: axial reconstruction via a cervical approach. J Vasc Surg. 2007, 46 (6): 1267-1269. 10.1016/j.jvs.2007.06.034.CrossRefPubMed
13.
MacLean AA, Vricella LA, Freischlag JA: Innominate artery aneurysm. Eur J Cardiothorac Surg. 2007, 32 (5): 803-10.1016/j.ejcts.2007.07.036.CrossRefPubMed
14.
Mori K, Kasuga C, Nakao Y, Yamamoto T, Maeda M: Intracranial pseudoaneurysm due to rupture of a saccular aneurysm mimicking a large partially thrombosed aneurysm (“ghost aneurysm”): radiological findings and therapeutic implications in two cases. Neurosurg Rev. 2004, 27 (4): 289-293.CrossRefPubMed
15.
Lane JD, Peirce EC: Endoaneurysmorrhaphy for spontaneous innominate artery aneurysm; report of a case with cure and an important diagnostic complication. Surgery. 1951, 30 (4): 709-717.PubMed
16.
Constenla I, Alvarez B, Yugueros X, Fernandez E, Bofill R, Matas M: Innominate artery aneurysm with hemoptysis and airway compression in a patient with bovine aortic arch. J Vasc Surg. 2012, 56 (3): 822-825. 10.1016/j.jvs.2012.03.241.CrossRefPubMed
17.
Oswal A, Mehra A, Karbhase J, Johari A, Karatela R, Shivdasani B: Combined resection of coronary and innominate artery aneurysms. J Card Surg. 2011, 26 (3): 319-321. 10.1111/j.1540-8191.2011.01246.x.CrossRefPubMed
18.
Lu C-Y, Lu M-S, Huang Y-K, Tsai F-C, Lin PJ: Innominate artery aneurysm as presentation of angiosarcoma. Surgery. 2011, 149 (4): 593-594. 10.1016/j.surg.2009.10.017.CrossRefPubMed
19.
Yuan S-M, Tager S: Penetrating atherosclerotic ulcer aneurysm of the innominate artery. VASA Zeitschrift für Gefässkrankheiten. 2009, 38 (3): 263-266.CrossRefPubMed
20.
Da Col U, Koukoulis G, Di Bella I, Ramoni E, Ragni T: Surgical treatment of ascending aorta and innominate artery trunk aneurysm with displaced brachiocephalic vessels. J Cardiovasc Med (Hagerstown). 2007, 8 (10): 852-854. 10.2459/JCM.0b013e3280110671.CrossRef
21.
Oruganti SS, Mishra RC: Traumatic giant true aneurysm of the brachiocephalic artery. Asian Cardiovasc Thorac Ann. 2006, 14 (4): 352-353. 10.1177/021849230601400419.CrossRefPubMed
22.
Saito A, Shiono M, Yamamoto T, Inoue T, Hata M, Sezai A, Iida M, Niino T, Hattori T, Negishi N, Sezai Y: Surgical treatment for innominate artery aneurysm with a coronary pulmonary artery fistula: a case report. Ann Thorac Cardiovasc Surg. 2005, 11 (1): 55-58.PubMed
23.
Chiappini B, Arpesella G, Barbara C, Pierangeli A: Delayed post-traumatic aneurysms of aorta, carotid and innominate arteries. European journal of cardio-thoracic surgery. 2001, 20 (6): 1246-1248. 10.1016/S1010-7940(01)00985-X.CrossRefPubMed
24.
Guibaud JP, Laborde MN, Dubrez J, Elia N, Remes J, Rosato F, Roques X, Baudet E: Surgical repair of an aneurysm of the innominate artery with fistulization into the trachea. Ann Vasc Surg. 2001, 15 (3): 412-414. 10.1007/s100160010070.CrossRefPubMed
25.
Najafi H, Overman D, Kavinsky CJ: An unusual combination of cardiovascular surgical disorders. Ann Thorac Surg. 1999, 67 (1): 241-244. 10.1016/S0003-4975(98)01148-5.CrossRefPubMed
26.
Villegas-Cabello O, Cooley DA: Aneurysm of the innominate artery with aberrant origin of the left carotid artery. Case report. Tex Hear Inst J. 1996, 23 (4): 298-300.
27.
Adkins MS, Gaines WE, Laub GW, Anderson WA, Fernandez J, McGrath LB: Management of an innominate artery aneurysm during an open heart operation. Ann Thorac Surg. 1993, 56 (2): 377-379. 10.1016/0003-4975(93)91185-P.CrossRefPubMed
28.
Thomas TV: Intrathoracic aneurysms of the innominate and subclavian arteries. J Thorac Cardiovasc Surg. 1972, 63 (3): 461-471.PubMed
29.
Ketonen P, Meurala H, Harjola PT, Mattila S, Ketonen L: Management of arteriosclerotic aneurysms of the innominate and subclavian arteries. Scand J Thorac Cardiovasc Surg. 1983, 17 (2): 129-133. 10.3109/14017438309109876.CrossRefPubMed
30.
Murray GF, Brawley RK, Gott VL: Reconstruction of the innominate artery by means of a temporary heparin-coated shunt bypass. J Thorac Cardiovasc Surg. 1971, 62 (1): 34-41.PubMed
31.
Zintel HA, Risbeck EC: Aneurysm of the bifurcation of the innominate artery. Successful excision and restoration of the carotid artery. Am J Surg. 1960, 99: 929-933. 10.1016/0002-9610(60)90490-6.CrossRefPubMed
32.
Ikonomidis JS, Kim PY, Crawford FA: Repair of aortic arch coarctation and innominate artery aneurysm with branched Dacron graft. J Thorac Cardiovasc Surg. 2004, 127 (2): 579-581. 10.1016/j.jtcvs.2003.10.017.CrossRefPubMed
33.
Takaba K, Aota M, Koike H, Konishi Y: Surgical treatment for intrathoracic aneurysm of the innominate artery in an 83-year-old asymptomatic woman. Jpn J Thorac Cardiovasc Surg. 2004, 52 (4): 194-197. 10.1007/s11748-004-0107-y.CrossRefPubMed
34.
Kasashima F, Urayama H, Ohtake H, Watanabe Y: Intrathoracic aneurysm of the innominate and right subclavian arteries: report of a case. Surg Today. 2001, 31 (1): 51-54. 10.1007/s005950170220.CrossRefPubMed
35.
Tominaga R, Tanaka J, Kawachi Y, Yoshitoshi M, Kohno H, Shiki K, Tokunaga K, Takahashi S: Surgical treatment of respiratory insufficiency due to tracheobronchial compression by aneurysms of the ascending aorta and innominate artery. J Cardiovasc Surg. 1988, 29 (4): 413-417.
36.
Schumacher PD, Wright CB: Management of of arteriosclerotic aneurysm of the innominate artery. Surgery. 1979, 85 (5): 489-495.PubMed
37.
Cook J: A report on three cases of innominate aneurysm. J R Coll Surg Edinb. 1960, 5: 298-303.PubMed
38.
Kirby CK, Johnson J: Innominate artery aneurysm treated by resection and end-to-end anastomosis. Surgery. 1953, 33 (4): 562-566.PubMed
39.
Yang G, Thompson D, Warren A: Late-appearing brachiocephalic aneurysm: an atypical vascular sequella of Kawasaki disease. Pediatr Cardiol. 2009, 30 (2): 197-199. 10.1007/s00246-008-9296-y.CrossRefPubMed
40.
Butman S, Gardin JM, Knoll M: Innominate artery aneurysm with thrombus: detection by two-dimensional echocardiography. J Am Coll Cardiol. 1983, 2 (2): 387-390. 10.1016/S0735-1097(83)80181-8.CrossRefPubMed
41.
Gordon-Taylor G: The surgery of the innominate artery, with special reference to aneurysm. Br J Surg. 1950, 37 (148): 377-404. 10.1002/bjs.18003714802.CrossRefPubMed
42.
De Bakey ME, Crawford ES: Resection and homograft replacement of innominate and carotid arteries with use of shunt to maintain circulation. Surg Gynecol Obstet. 1957, 105 (2): 129-135.PubMed
43.
Hejhal L, Firt P, Michal V, Hejnal J: Some interesting case reports in the field of reconstructive vascular surgery. J Cardiovasc Surg. 1965, 6 (5): 409-415.
Metadata
Title
Surgical treatment of innominate artery and aortic aneurysm: a case report and review of the literature
Authors
Erdinc Soylu
Leanne Harling
Hutan Ashrafian
Vania Anagnostakou
Dimitris Tassopoulos
Christos Charitos
John Kokotsakis
Thanos Athanasiou
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2013
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-8-141

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