Complications of Repair of the Supra-Aortic Trunks and the Vertebral Arteries

The supra-aortic trunks (SATs) are defined as those arteries that originate from the aortic arch and course through the mediastinum, terminating just proximal to the carotid bifurcation or the origin of the vertebral arteries. Atherosclerotic occlusive disease of the SATs or vertebral arteries may lead to a variety of cerebral or peripheral symptoms. Patients may demonstrate symptoms of either carotid or posterior circulation ischemia or upper extremity vascular insufficiency. Hypoperfusion and microembolic phenomena are mechanisms by which symptoms are generated. Such symptoms occur across a spectrum of patient subsets, including the arteritities, among which Takayasu arterititis is more frequent in the younger population.