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Wed Aug 22 13:20:36 BST 2007

Sal:

That begs an interesting thought:  Does the presence
of an aortic arch variation (ie. "bovine-TYPE" arch,
double arch, right arch, etc.) correlate with a higher
incidence of a concomitant cerebrovascular anomaly
(ie. fetal PCA)?

Ben Reynolds, PA-C
Pittsburgh, PA

--- SJASMD at aol.com wrote:

>  
> In a message dated 8/21/2007 6:09:53 PM W. Europe
> Daylight Time, 
> aneurysm_42 at yahoo.com writes:
> 
> Those pictures are INCREDIBLY informative, now I'm
> very glad that he received an aortogram; it made
> good
> sense to do the four vessel given his altered mental
> status without definite cause.  It probably saved
> the
> patient an intraoperative stroke.  
> 
> After reviewing the films, this is a case I would
> probably do under deep hypothermia and burst
> supression.  Sew like the wind!  
> 
> I still maintain that this injury is conventionally
> unstentable, but given the trajectory of this
> discussion I'm sure that Sal is going to show us
> that
> he was able to do the impossible.
> 
> Ben Reynolds, PA-C
> Pittsburgh, PA
> 
> ben
> one of the lessons i learned from this case was that
> a cerebral angiogram is 
> indicated when innominate injuries are identified on
> aortography..
>  
> The last patient I  angio'ed for an innominate
> injury had an occipital 
> cortical infarct resulting in field cut that went
> unrecognized during a two week 
> stay in the  ICU. 
>  
> I wonder how our surgical colleagues would approach
> this injury now
>  
> sal
> 
> 
> 
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