[Hemorrhages from the brachiocephalic trunk in prolonged artificial ventilation of the lungs and resuscitation].
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Adolescent↗
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Results for “Brachiocephalic Trunk”
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The influence of arm ischaemia and arm hyperaemia on subclavian and vertebral artery blood flow in patients with occlusive disease of the subclavian artery and the brachiocephalic trunk. A peroperative study.
A peroperative study of blood flow and flow direction was performed in series of patients with occlusive disease of the subclavian artery. Particular attention was focused on the flow variations caused by arm ischaemia and postischaemic hyperaemia and on the effect of injection of a vasodilator into the distal subclavian artery. The effect on blood flow and flow direction was measured with the aid of an electromagnetic flowmeter. During arm ischaemia induced by an inflated cuff on the arm, the subclavian flow diminished, as did the vertebral artery flow when it was retrograde. If the vertebral artery flow was anterograde, it increased during arm ischaemia. The postischaemic hyperaemia caused an increase of the subclavian flow and of reversed vertebral flow. If the vertebral flow was anterograde, it diminished during the postischaemic hyperaemia. Similar findings were obtained with intra-arterial injection of a vasodilator. The large amount of blood flow passing through the vertebral artery, as well as the flow variations caused by reactive arm hyperaemia, emphasize the role of this artery as a collateral vessel to the upper limb in cases of the subclavian steal phenomenon.
Adult↗
Structural considerations in tracheal disease.
Examinations were made of three sections of trachea obtained from eight dogs. The sections examined were at the regions of the second ring caudal to the larynx, the thoracic inlet, and the origin of the brachiocephalic trunk. Measurements were made of the lateral and ventrodorsal diameters, the lumen area of the trachea, the width and thickness of the tracheal cartilages, and the thickness of the trachealis muscle. Cell counts-per-square-micrometer of the cartilage and trachealis muscle were made. The results of these measurements were subjected to statistical analyses by means of one-way and two-way analyses of variance. The tracheal diameters, cartialge thickness, muscle thickness, and tracheal lumen area had significantly different measurements among the areas compared with both statistical methods. Ventrodorsal tracheal diameter and lumen area were not found to have significantly different measurements between the levels of the thoracic inlet and the brachiocephalic trunk. The cell counts did not have significantly different values among the areas considered when body weight was not a factor, but the values were significant when weight was a factor.
Analysis of Variance↗
[Arterio-tracheal fistula during long-term intubation of an awake patient. Case report (author's transl)].
Because of anterior softening of the trachea due to thyroid swelling a patient was intubated with a "Lanz-" endotracheal tube with low-pressure cuff after thyroidectomy. The awake, eating patient developed severe endotracheal haemorrhage during the 17 days of intubation. Thoracotomy revealed a 2 cm long horizontal rupture probably at the site of the tube tip at the anterior wall of the trachea. The opening was connected to a rupture of the right brachiocephalic trunk at its bifurcation. Interpositions of dacron prostheses between the trunk, the subclavian artery and the carotid artery and suture of the tracheal wall controlled the situation. However, the patient died from acute hepatic failure, as shown at post-mortem examination. This case report is a warning against long-term intubation of awake patients, as sometimes recommanded.
Brachiocephalic Trunk↗
Anomalous origin of a single coronary artery from the innominate artery.
This is the third reported case of the origin of a single coronary artery arising from the innominate artery (brachiocephalic trunk). Associated cardiovascular malformations were truncus arteriosus and a single ventricle. The term infant died 12 hours after birth. Heart failure, evidenced by severe pulmonary and hepatic congestion found at necropsy, was probably the immediate cause of death. The origin of a single coronary artery from sites other than the aortic or pulmonary sinuses is extremely rare and is always associated with other severe cardiac malformations. Truncus arteriosus and cor bioculare or trioculare are the usual associated abnormalities.
Brachiocephalic Trunk↗
Radiodiagnostic signs in pseudoxanthoma elasticum generalisatum (dysgenesis elastofibrillaris mineralisans).
The clinical symptomatology of patients suffering from pseudoxanthoma elasticum and the radiodiagnostic signs in four patients suffering from this disease have been reviewed. In these patients four groups of previously unpublished radiodiagnostic abnormalities were found. These are calcification of a number of ligaments; changes in the wall of brachiocephalic trunk, the right common, internal and external carotid arteries; fibro-osseous metaplasia of the long bones; dysplasia of the vertebrae. The authors believe that these changes are explicable by the general disorder of connective tissue and its derivatives which occurs in pseudoxanthoma elasticum.
Adult↗
Subclavian and innominate artery trauma. A five-year experience with 17 patients.
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Adult↗
[Basic problems of surgery in vascular atherosclerosis].
The author's opinion on the classification of atherosclerotic lesions of vessels is discussed and the peculiarities of the clinical picture, diagnosis, and surgical intervention in different localization of the lesions are analysed. An account is given of the basic propositions and principles of surgical management in atherosclerosis of the main localizations (aorta, brachiocephalic trunk, renal, mesenteric and other arteries). Sixteen-year experience in the surgical treatment of atherosclerotic vascular lesions is summarized. It is stressed that the results of reconstructive vascular operations, which were studied by the actuarial method, were good and permanent.
Abdomen↗
[Compressive brachio-cephalic arterial trunk and gastro-oesophageal reflux following surgery for oesophageal atresia (author's transl)].
6 cases of cardiorespiratory complications occurring after surgical treatment of oesophageal atresia are reported by virtue of the association of tracheal compression by the brachio-cephalic arterial trunk and of gastro-oesophageal reflux. In all cases, medical (2 cases) or surgical (4 cases) treatment of gastro-oesophageal reflux led to the disappearance of all respiratory symptoms and signs. Emphasis is placed upon the need for a routine and thorough search, radiological and endoscopic, of such associated oesophageal pathology, before proceeding to surgery on the compressive brachio-cephalic arterial trunk.
Brachiocephalic Trunk↗
[Closed trauma of the supra-aortic trunks (author's transl)].
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Adolescent↗
[Surgical treatment of occlusive lesions of the brahciocephalic trunk].
Surgery was performed on 41 patients for an occlusive process in the brachycephalic trunk. As concerns the clinical form of the occlusive process these patients were divided into 4 groups, viz. with symptomless occlusion--4, with transitory form--18, with chronic cerebro-vascular insufficiency--5 and with complete ischemic stroke--14. The diagnosis was established on the ground of routine clinical and instrumental examination findings. The authors consider an angiographic investigation of the patients to be indispensible. In the presence of an angiographically confirmed occlusion of the brachycephalic trunk the authors hold indicated reconstructive surgery in patients of all the mentioned clinical groups. As a basic type of the reconstructive operation is regarded resection of the trunk with prosthetics. The circulation could be restored in all of the patients operated upon. Late follow-up of the surgically treated patients (up to 10 years) proves that in the treatment of arterial insufficiency of the brain the reconstructive operation on the occluded brachycephalic trunk is a highly effective method.
Adult↗
Experimental method of producing total cerebral ischaemia in dogs.
Experimental method of producing total cerebral ischaemia in dogs. Acta Physiol. Pol., 1977, 28 (6): 585-588. It is very difficult to produce complete cerebral ischaemia in dogs in view of very abudant anastomoses between branches of carotid and vertebral arteries and muscle arteries. The methods applied for this purpose are technnically difficult and lead frequently to spinal cord injury or major metabolic distrubances in the whole organism. The reported investigations were carried out for elaboration of a method which would not have these disadvantages. Cerebral ischaemia was produced in dogs occluding the brachiocenhalic trunk and the left subclavian artery. The blood flow to the intercostal arteries and through them to the spinal artery was interrupted by means of a bypass between the aortic arch and the abdominal aorta. Isoelectric EEG line and lack of blood flow from the punctured carotid arteries were the criteria of complete ischaemia.
Animals↗
Management of early postoperative complications of arterial repairs.
Of 1,703 patients undergoing arterial procedures during a three-year period, 81 (4.7%) required reoperation within 72 hours because of early complications. Thrombosis (58 patients) and hemorrhage (19 patients) were the most frequent complications encountered. Reoperation was successful in salvaging a successful outcome in the majority of patients after both hemorrhagic and thrombotic complications. The results seem to justify a continued aggressive approach to the management of early complications following vascular reconstructive procedures.
Aorta, Abdominal↗
Innominate artery endarterectomy. A 16-year experience.
Transsternal endarterectomy was performed in 34 of 37 patients with symptomatic atherosclerosis of the innominate artery, with a mortality of 6%. Thirty of the 32 survivors are asymptomatic at an average of 6.1 years postoperatively. Six of these patients who had ulcerated, nonstenotic atherosclerotic lesions have had complete cessation of preoperative transient ischemic attacks. Normal arterial patency has been maintained for follow-up periods varying from seven months to 16 years.
Aged↗
Chronic upper extremity arterial insufficiency. Etiology, manifestations, and operative management.
Forty-eight arterial reconstructions were performed for chronic upper extremity ischemia in 43 patients, aged 31 to 81 years. Diagnostic arterial catheterization was the most frequent cause of symptomatic occlusion, followed by proximal arteriosclerotic lesions and noniatrogenic trauma. Doppler ultrasound evaluation provided important diagnostic and prognostic data that complemented information derived from arteriography. Indications for operation included disabling claudication (39 cases) or digital gangrene (four cases). Restoration of normal extremity function can be anticipated except in instances where poor forearm runoff exists. Autogenous saphenous and basilic interposition vein grafts have proved excellent for axillary-brachial revascularizations. Axillary-axillary bypass procedures for innominate-subclavian artery occlusions appear hemodynamically sound and technically simple. Follow-up, averaging 48 months, extended to 144 months. Late vein graft failure or progressive distal occlusive disease was not encountered.
Adult↗
Innominate artery disruption due to blunt trauma.
Two patients had innominate artery disruption due to blunt trauma. Compression forces between the sternum and vertebral column and rotational forces were the mechanisms of injury. Mediastinal widening led to the diagnosis in one patient who underwent successful repair with preservation of cerebral flow by an aortic to subclavian bypass graft prior to oversewing the innominate artery. A normal mediastinal shadow led to a delay in diagnosis in the second patient who underwent surgery after the appearance of focal neurologic signs. The use of a temporary indwelling aortic-carotid shunt during repair did not prevent residual hemiparesis.
Accidents, Traffic↗
A technique for the difficult peripheral arterial aneurysm.
Complete external control of the vessels feeding some aneurysms may be very difficult and occasionally only achieved at the cost of damage to surrounding structures. A method is described in which Foley catheters are introduced into the feeding vessels from within the aneurysm and then cut distal to their clamped side branch to enable Dacron grafts to be passed over them and sutured in place. This technique has been used in 3 patients with very satisfactory results and is offered as an alternative when standard control is hazardous, or impossible.
Adult↗
Right aortic arch with aberrant left innominate artery.
A 9-year-old girl with type D right aortic arch anomaly, has been presented. The diagnosis was based upon the presence of signs and symptoms of a vascular ring and the early visualization of a retroesophageal aberrant left innominate artery, by means of countercurrent right brachial angiography. Division of the ligamentum arteriosum at operation relieved the symptoms.
Aorta, Thoracic↗