Compressed true lumen in the innominate artery: A pitfall of right axillary arterial perfusion in acute aortic dissection

Abstract

Although axillary arterial perfusion (AX-P) is often preferred to femoral arterial perfusion (FA-P) in acute aortic dissection because it is associated with a lower incidence of malperfusion, it is unlikely to be perfect. We used near-infrared spectroscopy and orbital Doppler to detect cerebral malperfusion and transesophageal echocardiography (TEE) to clarify the malperfusion mechanism and observed a case of malperfusion after bilateral AX-P, which was relieved after interruption of the right AX-P. We report another case of malperfusion after right AX-P resulting from the narrowing of the innominate artery (IA) lumen.