For the first time in Armenia on 16.09.2014 at Erebouni MC was performed the operation with prosthetics of brachiocephalic trunk. This surgery was done by the head of the Neck Vessels Surgery service Dr. Shatahyan Mesrop (MD, PhD, Grand PhD)
Patient S. 56 years old, entered the Erebouni Medical Center with complains to periodic disturbances of speech, slow movements, loss of memory. According to CT angiography and duplex scanning of the patient it was revealed an extremely rare pathology - occlusion of the brachiocephalic trunk, with severe steal syndrome of vertebral and carotid artery on the right. In fact, the patient had inadequate blood supply of the right parts of the brain neck and right upper extremity, trunk (by 4-5 time less than the normal indexes), due to blockage of the aortic branch which was confirmed by the absence of pulsations in the right carotid and radial arteries. This pathology requires surgery to restore adequate blood flow - the imposition of the prosthesis from the ascending aorta to the distal portions of the brachiocephalic trunk. On 16.09.2014. the patient was taken to the operating room (surgery - Shatakhyan MP, Hayrapetyan A., Aleksanyan AN Stambolcian AV, an anesthesiologist - Muradyan, AR).To obtain best results for long-time period Dr. Shatakhyan had performed anatomical reconstruction of bypass (through sternotomy). After sternotomy a 12mm vessel graft was imposed from the ascending aorta to the bifurcation of the brachiocephalic trunk. Immediately after the placing of the prosthesis the right carotid and the upper limb's arteries' pulse had restored and the adequacy of blood flow data had been confirmed by duplex and Doppler studies. The patient was discharged on the 5th day in a satisfactory condition.
Stenosis or occlusion of the brachiocephalic trunk is extremely rare pathology. That is why the surgery for this pathology is very rare cases (particularly through sternotomy access). The studies in the world literature in this sphere are rare too. The presence of such kind of surgical methods and techniques allows saying that MC Erebouni has all necessary arsenal to perform high quality complex surgical intervention aimed to the prevention of cerebrovascular events - stroke.
