Skip to main content
Log in

Diagnostic dilemma in spontaneous innominate artery pathology: a case report

  • Case Report
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

We report the case of a 71-year-old female who presented with sudden onset of right cervical pain and ipsilateral arm hypoaesthesia. The diagnostic evaluation revealed a pathology of the origin of the innominate artery (IA). The differential diagnosis was among a spontaneous acute dissection and a ruptured pseudoaneurysm. The dilemma of the proper treatment emerged. Surgical or medical treatment? Open or endovascular approach? The patient was offered an open treatment under cardiopulmonary bypass and sort circulatory arrest. As less than ten cases of isolated IA dissection have been previously reported in the literature, we discuss the differential diagnosis difficulties and the treatment options.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. De Maria E, Olaru A, Cappelli S. Isolated innominate artery aneurysm: a very rare finding. Austin J Clin Case Rep. 2014;1:1041.

    Google Scholar 

  2. Kanady K, Hartz R, Massad M, Melen O, Russell E, Feingold R. Spontaneous isolated innominate artery dissection. Neurology. 1990;40(8):1315.

    Article  CAS  Google Scholar 

  3. Valverde A, Tricot JF, de Crepy B, Bakdach H, Djabbari K. Innominate artery involvement in type IV Ehlers-Danlos syndrome. Ann Vasc Surg. 1991;5:41–5.

    Article  CAS  Google Scholar 

  4. Munakata H, Okada K, Tanaka H, Yamashita H, Nakagiri K, Yutaka O. Acute dissection of the innominate artery: a case report. Gen Thorac Cardiovasc Surg. 2008;56:131–3.

    Article  Google Scholar 

  5. Lampropoulos S, Theofilogiannakos E, Gkontopoulos A, Kadoglou N, Mamalis V, Kontaki T, Kottas G. Syncope and cardiovocal syndrome as the result of a spontaneous innominate artery dissection. J Cardiovasc Med. 2009;10:815–7.

    Article  Google Scholar 

  6. Sansone T, Baroncelli S, Tozzetti C, Berni A, Torri M. Challenges in management of ischemic stroke secondary to brachiocephalic artery dissection. Intern Emerg Med. 2013;8:181–3.

    Article  Google Scholar 

  7. Mani H, Ahluwalia S (2015) Isolated brachiocephalic artery dissection presenting as acute stroke. BMJ Case Rep.

  8. Khatib AZ, Powles AJ, L Gan CJ: Brachiocephalic artery dissection. https://www.eurorad.org/case.php?id=13682.

  9. Nagata T, Johno H, Wang Y, Asanuma M. Isolated innominate artery dissection. J Card Surg. 2017;32:710–1.

    Article  Google Scholar 

  10. Sakamoto H, Hattori T, Watanabe Y, Sakakibara Y. Chronic post-traumatic pseudo-aneurysm of the brachiocephalic artery with tracheal obstruction resulting in repeated pneumonia. Ann Thorac Surg. 2006;82:1101–3.

    Article  Google Scholar 

  11. Hirose H, Moore E. Delayed presentation and rupture of a posttraumatic innominate artery aneurysm: case report and review of the literature. J Trauma. 1997;42:1187–95.

    Article  CAS  Google Scholar 

  12. Kasashima F, Urayama H, Ohtake H, Watanabe Y. Intrathoracic aneurysm of the innominate and right subclavian arteries: report of a case. Surg Today. 2001;31:51–4.

    Article  CAS  Google Scholar 

  13. Kieffer E, Chiche L, Koskas F, Bahnini A. Aneurysms of the innominate artery: surgical treatment of 27 patients. J Vasc Surg. 2001;34:222–8.

    Article  CAS  Google Scholar 

  14. Li X, Guo Y, Ziegler K, Model LS, Eghbalieh SDD, Brenes RA, Kim ST, Shu C, Dardik A. Current usage and future directions for the bovine pericardial patch. Ann Vasc Surg. 2011;25(4):561–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christophoros Kotoulas.

Ethics declarations

Conflict of interest

Kotoulas Christophoros, Georgiou Charalampos, Chouliaras Elefterios, Theodosiadis Nikolaos, Kotoulas Sotirios, Kotoulas Athanassios and Panagiotou Ioannis has no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kotoulas, C., Georgiou, C., Chouliaras, E. et al. Diagnostic dilemma in spontaneous innominate artery pathology: a case report. Gen Thorac Cardiovasc Surg 69, 367–370 (2021). https://doi.org/10.1007/s11748-020-01472-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-020-01472-6

Keywords

Navigation