Key result
Total replacement of the aortic arch successfully prevented further ischemic events over 9 months of follow-up in a patient with repeated brain infarctions caused by atherosclerosis of a bovine aortic arch.
Why the study?
Does surgical aortic arch replacement prevent recurrent brain infarction in a patient with severe atherosclerosis of a bovine aortic arch refractory to medical therapy?
Case Report (n=1)
No
Does surgical aortic arch replacement prevent recurrent brain infarction in a patient with severe atherosclerosis of a bovine aortic arch refractory to medical therapy?
Surgical aortic arch replacement may be an effective treatment for preventing recurrent embolic stroke in patients with severe atherosclerosis of a bovine aortic arch when intensive medical therapy fails and endovascular options are unsafe.
A 62-year-old man presented with repeated embolic infarction over the last 3 years. Computed tomography angiography of the aortic arch revealed that the patient had a common trunk for the innominate and left carotid arteries, the so-called bovine aortic arch, with stenosis extending to both the left common carotid artery and innominate artery. Since antiplatelet therapy was not adequate for prevention of recurrent infarction, total replacement of the aortic arch was performed. Since then, no further ischemic events have manifested. Endovascular procedures are not safe enough for atherosclerotic lesions in the aortic arch, especially in a patient with bovine aortic arch, so surgical aortic arch replacement should be considered.
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YAMASHITA et al. (2012) conducted a case report in Repeated brain infarction caused by atherosclerosis of the bovine aortic arch (n=1). Total replacement of the aortic arch was evaluated on Recurrence of ischemic events. Total replacement of the aortic arch successfully prevented further ischemic events over 9 months of follow-up in a patient with repeated brain infarctions caused by atherosclerosis of a bovine aortic arch.
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