A Case Report of Fatal Cerebellar and Brainstem Infarction Accompanying Clamping of the Left Subclavian Artery during Operation for Thoracic Aortic Aneurysm.
10.4326/jjcvs.22.510
- VernacularTitle:左鎖骨下動脈遮断により致命的な小脳，脳幹部梗塞を合併した胸部大動脈リゅうの１手術例
- Author:
Hajime OTANI
;
Yoshiya SAKURAI
;
Kazuho TANAKA
;
Michio FUKUNAKA
;
Hiroji IMAMURA
;
Nobuyuki SAKAI
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1993;22(6):510-513
- CountryJapan
- Language:Japanese
-
Abstract:
The authors experienced a case of fatal cerebellar, and brainstem infarction accompanying clamping of the left subclavian artery during operation for thoracic aortic aneurysm. Autopsy of this case revealed that right vertebral artery became markedly hypoplastic distal to the posteroinferior cere bellar artery, and left vertebral and basilar arteries were occluded by thrombus formation. These findings indicate that clamping of the dominant left subclavian artery is responsible for severe vertebrobasilar ischemia producing the fatal brain infarction. Since the occurrence of this devastating complication, we have performed pancerebral angiography and balloon occlusion test of the left subclavian artery in patients who might undergo proximal clamping of the aortic arch between the left carotid artery and the left subclavian artery during operations for thoracic aortic aneurysm. Selective perfusion of the left subclavian artery is then planned for those with abnormal vertebrobasilar communications producing neurological signs.
