Purpose: To measure the age-dependent changes of anatomical positions and relations between the trachea, cricoid cartilage (CC), and innominate artery (IA) in adults by computed tomography (CT).
Methods: A retrospective cohort reviewing images of 127 consecutive adult patients who underwent CT angiography (CTA) of the neck. The trachea-to-IA (T-IA) distance was measured as the minimal horizontal distance between them. The vertical distance between the CC and the IA was measured between the axial section, demonstrating the CC's inferior border to the axial section at the level of the T-IA measurement.
Results: Images of 125 patients (median age 53 years, range 18-89; 74 males) were reviewed. The mean T-IA distance was 2.3 ± 1.1 mm for males and 1.7 ± 0.9 mm for females (P = 0.002). The vertical C-IA distance was 44.2 ± 11.4 mm and 49.5 ± 12.5 mm for males and females, respectively (P = 0.01). Age correlated negatively with the vertical C-IA distance (P < 0.0001) and positively with the T-IA distance (P < 0.0001). The rate of IA variants was 23.2%, with no significant difference between the measurements of distances among patients with or without IA variants.
Conclusions: This is the first description of the relationships between the trachea, CC, and IA distances in adults as depicted on CTA. The T-IA distance becomes larger while the T-CC distance becomes shorter with age.
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http://dx.doi.org/10.1007/s00405-019-05474-w | DOI Listing |
JACC Case Rep
January 2025
Chinese Institutes for Medical Research and Anzhen Hospital, Capital Medical University, Beijing, China.
Although open repair remains the mainstream treatment for aortic arch dissection, its surgical complexity and perioperative complications are significant. We developed a novel stentgraft system for less-invasive endovascular aortic arch repair. We successfully performed a total percutaneous transfemoral endovascular repair of aortic arch dissection using a novel off-the-shelf endograft system.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
October 2024
Department of Vascular and Endovascular Surgery, St Francis Hospital & Heart Center, Roslyn, NY, USA.
The optimal management of acute type A aortic dissection (ATAAD) remains a controversial subject. While some surgeons opt for a hemiarch approach to minimize bypass and cross-clamping time, others prefer partial or total arch replacement to prevent the need for additional operations. The advent of hybrid approaches offers a variety of options to the aortic surgeon in treating ATAAD.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
January 2025
Heart Institute, Le Bonheur Children's Hospital, Memphis, TN, USA.
Background: Impella 5.5 ventricular assist device (VAD) insertion is typically done via the axillary artery or directly through the aorta; however, an axillary artery must be ≥6 mm in diameter, which excludes many pediatric patients who do not meet this criterion. The innominate artery is a larger vessel that can better accommodate the Impella VAD in pediatric patients.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
February 2025
Department of Surgery, George Washington University Hospital, Washington, DC.
Acute limb ischemia is a critical vascular emergency often resulting from embolic sources, requiring prompt intervention to prevent significant morbidity and mortality. This paper presents a case of a 74-year-old female with acute limb ischemia due to a thromboembolus in the distal brachial artery and a nonocclusive mobile thrombus in the innominate artery. The patient underwent urgent brachial artery thromboembolectomy and subsequent retrograde innominate artery stenting via right open transcarotid approach.
View Article and Find Full Text PDFVascular
January 2025
Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.
Objectives: Mal-deployment of the thoracic endovascular aortic repair (TEVAR) stent graft during a frozen elephant trunk (FET) procedure for an acute type A aortic dissection (ATAAD) leads to devastating complications. We report a hemiarch replacement with TEVAR stent graft covering the aortic arch vessels salvaged through an endovascular approach.
Methods: A 69-year-old man with ATAAD in 2018, status post-hemiarch repair with TEVAR, presented in 2023 with progressive dizziness/syncope and lower extremity hypertension with inability to tolerate anti-hypertensives.
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