Staged surgical treatment of a woman with nonspecific aortoarteritis and bilateral occlusion of carotid arteries

Zotikov A.E., Ivandaev A.S., Gontarenko V.N., Kozhanova A.V., Timina I.E., Kulbak V.A.

Institute of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health, Moscow, Russia

Nonspecific aortoarteritis (NAA) is an autoimmune disease characterized by the development of an inflammatory process in large arteries such as the aorta and its branches and pulmonary arteries. Operative interventions for lesions of the aortic arch branches may be divided into extra- and transthoracic. Involvement of all branches of the aortic arch requires transthoracic interventions to be performed. According to the findings of various authors, bicarotid bypass grafting is accompanied by a high incidence rate of complications and lethal outcomes. The most serious complication is haemorrhagic stroke developing in 40 % of patients. That is why commencing from 1991 the practice of simultaneous restoration of the two carotid basins was discontinued.

A clinical case report presented herein demonstrates the authors’ therapeutic policy in patients with NAA and multiple involvement of brachiocephalic arteries and first of all with bicarotid occlusion.

KEY WORDS: nonspecific aortoarteritis, Takayasu disease, aortocarotid bypass.

P. 174

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