TL;DR: Injury progression in grade I-II BAI is rare (~5%) and did not cause death in the study cohort, given that progression to grade III injury is possible, follow-up with repeat aortic imaging is reasonable.
TL;DR: None of the last 39 patients has become paraplegic, as vasodilator treatment is now discontinued during the cross-clamp period, as there was no evidence of new or increased intraabdominal bleeding during heparinization.
TL;DR: Transesophageal Doppler echography provides a rapid and accurate method of diagnosing and evaluating dissecting aortic aneurysm and permits prompt initiation of appropriate treatment.
TL;DR: In the first case two incisions in the neck were needed to settle the diagnosis and to permit thromboendarterectomy at the level of the carotid sinus; in the second, a bifurcated nylon tube was inserted to lead from the aorta past the obstructed brachiocephalic trunk to the right subclavian and common caratid arteries.
Abstract: Thrombo-obliterative disease of the branches of the aortic arch causes symptoms of ischemia in the head and upper extremities. In the two cases here described it was sharply delimited. In the first case its location was determined with the help of aortography; in the second, the physical findings with usual chest roentgenograms sufficed. In the first case two incisions in the neck were needed to settle the diagnosis and to permit thromboendarterectomy at the level of the carotid sinus; in addition, a right anterior thoracotomy in the second interspace was needed, and a bifurcated nylon tube was inserted to lead from the aorta past the obstructed brachiocephalic trunk to the right subclavian and common caratid arteries. In the second case an obstruction involving the left subclavian artery was removed by thromboendarterectomy. Normal pulsations reappeared in the arteries distal to the site of operation in each case. Both patients were relieved of symptoms and were able to return to work.
TL;DR: MRI with MRA provides the relevant information needed for follow-up of endoluminally treated abdominal aortic aneurysms (AAA), and may be the method of choice because of its use of contrast media with very low nephrotoxicity, lack of ionising radiation and non-invasiveness.