Repeated Brain Infarction Caused by Atherosclerosis of the Bovine Aortic Arch Successfully Treated With Arch Replacement

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  • YAMASHITA Tae
    Department of Neurosurgery, Hamamatsu University School of Medicine
  • HIRAMATSU Hisaya
    Department of Neurosurgery, Hamamatsu University School of Medicine
  • WASHIYAMA Naoki
    Department of Cardiovascular Surgery, Hamamatsu University School of Medicine
  • SHIIYA Norihiko
    Department of Cardiovascular Surgery, Hamamatsu University School of Medicine
  • NAMBA Hiroki
    Department of Neurosurgery, Hamamatsu University School of Medicine

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  • —Case Report—

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A 62-year-old man presented with repeated embolic infarction over the last 3 years. Computed tomography angiography of the aortic arch revealed that the patient had a common trunk for the innominate and left carotid arteries, the so-called bovine aortic arch, with stenosis extending to both the left common carotid artery and innominate artery. Since antiplatelet therapy was not adequate for prevention of recurrent infarction, total replacement of the aortic arch was performed. Since then, no further ischemic events have manifested. Endovascular procedures are not safe enough for atherosclerotic lesions in the aortic arch, especially in a patient with bovine aortic arch, so surgical aortic arch replacement should be considered.<br>

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