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Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report

INTRODUCTION AND IMPORTANCE: Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to dissection or vasculitis. Atherosclerotic diseas...

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Autores principales: Tesar, Joshua, Favot, Danella, Williams, Livia, Tesar, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020438/
https://www.ncbi.nlm.nih.gov/pubmed/33756170
http://dx.doi.org/10.1016/j.ijscr.2021.105780
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author Tesar, Joshua
Favot, Danella
Williams, Livia
Tesar, Peter
author_facet Tesar, Joshua
Favot, Danella
Williams, Livia
Tesar, Peter
author_sort Tesar, Joshua
collection PubMed
description INTRODUCTION AND IMPORTANCE: Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to dissection or vasculitis. Atherosclerotic disease of the supra-aortic branch vessels is commonly managed via an endovascular approach. We report a rare and atypical presentation of cerebral malperfusion in the setting of atherosclerotic disease of the innominate and carotid arteries managed with an aorto-carotid bypass graft. CASE PRESENTATION: A case report of an 80-year-old female presenting with orthostatic mediated hypoperfusion transient ischaemic attacks with episodes of limb shaking and unilateral weakness with postural changes. The malperfusion was in the setting of severe atherosclerotic disease of the innominate and carotid arteries. CLINICAL DISCUSSION AND CONCLUSION: Our patient was not amendable to endovascular intervention or a less invasive open approach. The patient underwent an aorto-carotid bypass graft with complete resolution of symptoms. This case highlights a rare manifestation of orthostatic mediated cerebral malperfusion and a successful novel treatment method.
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spelling pubmed-80204382021-04-08 Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report Tesar, Joshua Favot, Danella Williams, Livia Tesar, Peter Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to dissection or vasculitis. Atherosclerotic disease of the supra-aortic branch vessels is commonly managed via an endovascular approach. We report a rare and atypical presentation of cerebral malperfusion in the setting of atherosclerotic disease of the innominate and carotid arteries managed with an aorto-carotid bypass graft. CASE PRESENTATION: A case report of an 80-year-old female presenting with orthostatic mediated hypoperfusion transient ischaemic attacks with episodes of limb shaking and unilateral weakness with postural changes. The malperfusion was in the setting of severe atherosclerotic disease of the innominate and carotid arteries. CLINICAL DISCUSSION AND CONCLUSION: Our patient was not amendable to endovascular intervention or a less invasive open approach. The patient underwent an aorto-carotid bypass graft with complete resolution of symptoms. This case highlights a rare manifestation of orthostatic mediated cerebral malperfusion and a successful novel treatment method. Elsevier 2021-03-16 /pmc/articles/PMC8020438/ /pubmed/33756170 http://dx.doi.org/10.1016/j.ijscr.2021.105780 Text en © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Tesar, Joshua
Favot, Danella
Williams, Livia
Tesar, Peter
Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title_full Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title_fullStr Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title_full_unstemmed Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title_short Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report
title_sort aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020438/
https://www.ncbi.nlm.nih.gov/pubmed/33756170
http://dx.doi.org/10.1016/j.ijscr.2021.105780
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