Case report

https://doi.org/10.21860/medflum2021_261193

Acute left arm ischemia after TEVAR due to the anatomical variation of the vertebral artery – case report

Josip Figl orcid.org/0000-0001-6755-8656 ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Damir Halužan ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Predrag Pavić ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Tomislav Meštrović ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Irena Šnajdar ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Dino Papeš ; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia

Abstract

Aim: In this case we report acute left arm ischemia after thoracic endovascular aortic repair of the saccular thoracic aortic aneurysm due to a rare anatomical variation of the left vertebral artery. Case report: Thoracic aortic stent-graft was deployed to cover the aneurysm, but six hours later acute left arm ischemia occurred due to a rare form of vertebral artery origin from the aortic arch instead of from the left subclavian artery. This hostile anatomy led to an iatrogenic acute ischemia which was the indication for an emergency left-common-carotid-to-subclavian-artery bypass grafting. Conclusion: Multidisciplinary approach and careful pre-procedural planning should always be the standard procedure in complex cases to avoid this complication.

Keywords

carotid artery; ischemia; subclavian artery; thoracic aortic aneurysm; vertebral artery

Hrčak ID:

261193

URI

https://hrcak.srce.hr/261193

Publication date:

1.9.2021.

Article data in other languages: croatian

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