Habash Nicola M, Chao Calvin L, Reddy Nidhi K, Eskandari Mark K
Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
J Vasc Surg Cases Innov Tech. 2025 Jun 20;11(5):101891. doi: 10.1016/j.jvscit.2025.101891. eCollection 2025 Oct.
Innominate artery occlusive disease (IAOD) is an uncommon yet significant cause of cerebral and upper extremity ischemia, often requiring revascularization. We present a case series of patients with symptomatic IAOD managed with carotid-to-carotid bypass, highlighting three distinct clinical scenarios, including failed prior endovascular intervention, extensive supra-aortic trunk calcification, and high surgical risk prohibiting sternotomy. Our findings emphasize key considerations in IAOD management, including patient selection, technical feasibility, and long-term outcomes of extra thoracic revascularization. Despite complex comorbidities, carotid-to-carotid bypass provided sustained symptom relief and graft patency in our cohort. A patient-centered approach remains essential for optimizing outcomes in this population.
无名动脉闭塞性疾病（IAOD）是导致脑和上肢缺血的一种少见但重要的病因，常需进行血管重建。我们展示了一组采用颈动脉-颈动脉搭桥术治疗的有症状IAOD患者的病例系列，突出了三种不同的临床情况，包括既往血管内介入治疗失败、主动脉弓上干广泛钙化以及手术风险高而禁止开胸手术。我们的研究结果强调了IAOD治疗中的关键考虑因素，包括患者选择、技术可行性以及胸外血管重建的长期结果。尽管存在复杂的合并症，但颈动脉-颈动脉搭桥术在我们的队列中提供了持续的症状缓解和移植物通畅。以患者为中心的方法对于优化该人群的治疗结果仍然至关重要。
