Innominate Artery Disease

Definition

Innominate artery disease involves blockages in the artery that supplies blood to the right arm and head and neck. Also known as the brachiocephalic artery, the innominate artery is the first branch from the aortic arch, the top portion of the main artery carrying blood away from the heart.

Causes

• Hardening of the arteries (atherosclerosis)
• Trauma
• Takayasu's arteritis
• Radiation arteritis
  

Risk

• High blood pressure
• Diabetes
• Smoking
• High cholesterol
  

Symptoms

• Dizziness

• Blurred vision
• Weakness
• Transient ischemic attacks, or "mini-strokes"
• Sudden changes in blood pressure
• Reduced pulse
• Arm numbness or fatigue with use
  

Diagnosis

• Doppler and Ultrasound Imaging: Sound waves are used to measure blood flow in the artery and determine whether there is a blockage.
• Computed Tomography (CT) scan and CT Angiography: X-ray slices of the neck and brain are taken to determine if there are any areas with poor blood flow or narrow arteries. Patients may be injected with a dye that will help make blood vessels visible on the scan.
• Angiography: A dye is inserted into the arteries through a catheter, then an X-ray is taken to show how blood flows through the arteries and whether any arteries are narrowed or blocked.
  

Treatment

• Endarterectomy: An endarterectomy is a surgical procedure where plaque causing a narrowing or blockage in the aortic arch arteries is removed, opening the affected artery and improving blood flow. It is performed infrequently.
• Angioplasty and stenting: In this procedure, a surgeon inserts a catheter with a balloon on its tip and runs it to the area of the artery that is blocked or narrowed. The balloon is inflated, pushing the plaque to the artery walls and opening up the artery. A small tube called a stent is then inserted to keep the artery open.
• Bypass grafting: A surgical procedure that creates a bypass from the ascending aorta beyond the blockage to the carotid arteries or to the innominate artery.