Endovascular management of aortic dissections involving the common carotid and subclavian arteries

Abstract

Aortic dissection is a life-threatening condition, in which rupture of the internal wall of the aorta is observed. The aim of the study was to present the techniques used in patients with type A Stanford aortic dissection treatment by means of carotid-carotid by-pass surgery and implantation of the aortic stent-graft with intentional occlusion of the left common carotid and subclavian arteries. Surgical methods were presented on the basis of three patients treated at the Department of Vascular, General and Oncological Surgery, Memorial Copernicus Hospital in Łódź. Different carotid- carotid bypass grafting techniques were also described. Our own clinical observations demonstrated that patients with retro-pharyngeal carotid-carotid bypass did not report dysphagia, and retropharyngeal grafting seems to be the optimal method considering patients in whom stent-grafts cause left carotid artery occlusion.