Symptomatic obstruction of the brachiocephalic and left subclavian arteries obscured by aortic stenosis.

Journal Article (Journal Article)

Stenosis or occlusion of the brachiocephalic artery represents an uncommon cause of cerebrovascular insufficiency. We report a patient with combined brachiocephalic and left subclavian obstruction with clinical manifestations of lightheadedness, syncope, and left-sided weakness who remained misdiagnosed essentially because of symmetrical pressures in the upper extremities. Aortic valve replacement for aortic stenosis failed to provide symptomatic relief. Eventual stenting of the brachiocephalic trunk resolved the patient's symptoms. Our report highlights the diagnostic challenges in this case of bilateral supraaortic vessel disease and shows that equal upper extremity pressures do not rule out brachiocephalic artery obstruction.

Full Text

Duke Authors

Cited Authors

  • Hashim, PW; Assi, R; Grecu, L; Dardik, A

Published Date

  • April 2014

Published In

Volume / Issue

  • 28 / 3

Start / End Page

  • 737.e1 - 737.e5

PubMed ID

  • 24368183

Electronic International Standard Serial Number (EISSN)

  • 1615-5947

Digital Object Identifier (DOI)

  • 10.1016/j.avsg.2013.04.030


  • eng

Conference Location

  • Netherlands