• Ann Vasc Surg · Jul 2014

    Case Reports

    Subclavian stump syndrome causing a posterior circulation stroke after thoracic endovascular aneurysm repair (TEVAR) with adjunctive carotid to subclavian bypass and endovascular embolization of the left subclavian artery.

    • Ritesh Patel, Carl Muthu, and Kwat Huat Goh.
    • Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand.
    • Ann Vasc Surg. 2014 Jul 1; 28 (5): 1318.e13-6.

    BackgroundEndovascular repair of thoracic aortic pathology has become increasingly common over the last decade. We highlight the case of an intentionally occluded left subclavian artery stump acting as a source of emboli after thoracic endovascular aneurysm repair (TEVAR) for type B dissection.MethodsA 68-year-old man underwent TEVAR of a type B thoracic aortic dissection. A carotid subclavian bypass was performed, and an AMPLATZER™ endovascular plug (to occlude the left subclavian artery origin) was used to create an adequate proximal landing zone.ResultsThe patient presented with a posterior circulation stroke 2 years later, which was thought to be due to emboli originating from the occluded subclavian artery stump.ConclusionsConsideration should be given to ligating the subclavian artery immediately proximal to the vertebral artery origin when performing adjunctive carotid subclavian bypass during TEVAR. If this is not done, surveillance computed tomography scans should monitor for the development of propagating thrombus in the subclavian stump.Copyright © 2014 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…