Axillary-Axillary Bypass Grafting for Subclavian Steal Syndrome with Progressive Aphasia
- VernacularTitle:失語を伴う脳梗塞を発症した左鎖骨下動脈盗血症候群に対し腋窩-腋窩動脈バイパス術を施行した1例
- Author:
Hayate NOMURA
1
;
Yukihiro HAYATSU
1
;
Fumiya HABA
1
;
Kazuhiro YAMAYA
1
;
Masaki HATA
1
Author Information
- Keywords: subclavian steel syndrome; axillary-axillary bypass; aphasia
- From:Japanese Journal of Cardiovascular Surgery 2022;51(1):57-60
- CountryJapan
- Language:Japanese
- Abstract: A 79-years-old female underwent total arch replacement for an aortic arch aneurysm. A postoperative CT scan showed no abnormalities on the anastomotic sites, including the supra-aortic neck vessels. However, 10 months after the operation, she visited our outpatient clinic to complain of left shoulder pain. A CT scan demonstrated complete occlusion of the left subclavian artery, and doppler echography detected a subclavian steal phenomenon. Eleven months after the operation, the patient was transferred to our hospital because of the transient loss of consciousness and progressive aphasia. MRI revealed hyperintensive lesions in the boundary area between the left temporal and occipital lobes, enlarged in a DWI (diffusion-weighted image) with time. Axillary-axillary bypass grafting was performed to suppress the progression of cerebral ischemia caused by a subclavian steal phenomenon. Aphasia seemed to be improved soon after the bypass and diminished on postoperative day 2. The hyperintensive area on DWI regressed, and no other lesion was found on a postoperative MRI. She was discharged without apparent sequelae, including aphasia. We report a successful case of revascularization for subclavian steal syndrome with aphasia.
