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Innominate steal syndrome–a hybrid approach

Journal of Cardiology & Current Research
Nelson Camacho, Carlos Amaral, Gonçalo Alves, Joana Catarino, Ricardo Correia, Rita Bento, Maria Emília Ferreira

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Innominate steal phenomenon is a rare clinical finding, characterized by a flow inversion of a segment or the entire carotid axis, caused by a stenosis/occlusion of the innominate artery. 64-years-old male was admitted with dizziness, paresthesia and claudication on right arm. Color duplex scan (CDS) revealed severe stenosis of the innominate artery and total flow inversion of the right internal carotid artery. Surgery consisted of puncture of right brachial artery and exposure of right common carotid artery (CCA). A kissing stent technique was performed with a covered stent on the right CCA and balloon-expandable stent on the right subclavian artery. The postoperative period was uneventful. This case demonstrates the importance of CDS on diagnosing proximal lesions on supra-aortic vessels and the feasibility of a hybrid endovascular approach to treat innominate artery lesions with complete cerebral protection.


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