Supra-aortic vessels XXXX : diagnosis and prompt intervention.

@entity1 @entity887 @entity397 @entity439 @entity715
PURPOSE: @entity439 involving the supra-aortic vessels are rare but carry serious risk of embolization, @entity715 , and @entity397 . We describe our experience with the diagnosis, treatment strategies, and outcomes in @entity1 with extended follow-up. METHODS: Data during a 17-year period (January 1990 to December 2007) was analyzed. We assessed age, gender, presenting symptoms, localization, pathologic diagnosis, type of procedures, complications, and survival. RESULTS: A total of 74 @entity1 were treated for supra-aortic @entity439 . Of all @entity439 treated, 63% were degenerative, 24% iatrogenic, 8% traumatic, 3% genetic, and 1% mycotic. The subclavian artery was most commonly affected (50%, 2/3 in the right side), followed by the common carotid (36%), internal carotid (10%), innominate (3%), and vertebral (1%). At the time of diagnosis, 52 @entity1 (70%) were asymptomatic, but of those symptomatic 68% had an embolic event as a presenting symptom. @entity887 were more common in @entity1 with smaller @entity439 (P < .006). Open surgery was performed in 77% of all cases, and the use of endovascular techniques became the predominant treatment modality over the last 4 years. Survival at 30 days was 100%. Five- and 10-year survival rates were 87% and 43%, respectively. CONCLUSION: Most cases of supra-aortic @entity439 are asymptomatic and embolization as opposed to @entity397 represents the greatest risk to the @entity1 . Most cases can be detected prior to symptoms. Endovascular repair is an emerging alternative of treatment and, with the current development of appropriate devices, will likely form the mainstay of therapy in the near future.
