Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №2

SURGICAL MANAGEMENT OF LESIONS OF AORTIC ARCH BRANCHES

N.S. Abushev, F.D. Dzheiranov, G.T. Tagi-Zade, Sh.M. Gadzhiev, S.S. Manafov, O.A. Gadzhiev, A.A. Aliev, I.Kh. Mustafaev, E.N. Aliev
Department of Vascular Surgery, M.A. Topchibashev Research Institute of Clinical and Experimental Surgery,
Baku, Azerbaijan

The aim of the present work was to summarize the experience we gained and to raise the efficacy of the surgical treatment of patients with injuries of aortic arch branches (carotid arteries, vertebral artery, subclavian artery, brachiocephalic trunk). The results obtained in 29 patients operated on between January 1986 and June 1997 are analyzed. The mean age of the patients was 26.7±1.6 years. Of these, 4 (13.8%) patients died: the cause of death was hemorrhagic shock induced by massive blood loss (2 cases), cerebral ischemia, and concomitant cranioce-ebral injury. In the short-term postoperative period, the following complications were recorded: thromboembolism with hemiparesisone case (3.4%), marginal necrosis of the cutaneous wound – 3 cases (10.3%), pneumonia – 2 cases (6.9%), bronchopleural-cutaneous fistula – one case (3.4%). It is concluded that the majority of patients with injuries of aortic arch branches demonstrate the clinical signs of vascular injury and that arteriography has a high diagnostic accuracy and is indicated in patients having stable central hemodynamics, with open injuries lodged in zones I and III and in those with closed injuries. We hold that patients with or without the central neurologic deficit should undergo cerebral vascularization. In arterial reconstructions, the autogenous vein should be viewed as material of choice.

P. 115-123

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