Management of a spontaneous supra-aortic arterial dissection: a case report
Open Access
- 2 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Medical Case Reports
- Vol. 15 (1), 1-4
- https://doi.org/10.1186/s13256-021-02886-3
Abstract
Background Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae. Case presentation A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management—anti-impulse regimen, antiplatelet therapy, and close follow-up. Conclusions Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.Keywords
This publication has 9 references indexed in Scilit:
- Nonoperative Management of Brachiocephalic Artery DissectionThe Annals of Thoracic Surgery, 2019
- Isolated innominate artery dissectionJournal of Cardiac Surgery, 2017
- Anticoagulation vs Antiplatelet Treatment in Patients with Carotid and Vertebral Artery Dissection: A Study of 370 Patients and Literature ReviewNeurosurgery, 2017
- Isolated brachiocephalic artery dissection presenting as acute stroke: Figure 1BMJ Case Reports, 2015
- Spontaneous Cervical and Cerebral Arterial DissectionsNeuroimaging Clinics of North America, 2013
- Syncope and cardiovocal syndrome as the result of a spontaneous innominate artery dissectionJournal of Cardiovascular Medicine, 2009
- Acute dissection of the innominate artery: A case of reportGeneral Thoracic and Cardiovascular Surgery, 2008
- Aortic Dissection: New Frontiers in Diagnosis and ManagementJournal of the American College of Cardiology, 2003
- Aneurysms of the innominate artery: Surgical treatment of 27 patientsJournal of Vascular Surgery, 2001