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June 1962

Occlusive Lesions of the Great Vessels of the Aortic Arch: Surgical and Pathological Aspects

Author Affiliations

Dr. Czarnecki's present address: Fitzsimmons General Hospital, Denver.; Dr. Cohen's present address: U.S. Army Hospital, Munich, APO 407, U.S. Forces.; From the Department of Surgery, Walter Reed General Hospital, Washington, D.C., and Cardiovascular Pathology Branch, Armed Forces Institute of Pathology, Washington 25, D.C.; Department of Surgery, The Johns Hopkins University School of Medicine and Hospital (Dr. Spencer); Department of Surgery, Baylor University School of Medicine (Dr. DeBakey).

Arch Surg. 1962;84(6):628-642. doi:10.1001/archsurg.1962.01300240032006

Among the earliest descriptions of occlusive disease at or near the origin of the major branches of the aortic arch were those by Savory in 185618 and by Broadbent in 1875.2 The various terms subsequently applied to this condition have included, "pulseless disease," "reversed coarctation," "aortic arch syndrome," "young female arteritis," and "chronic subclavian obstruction syndrome." Whatever the terminology used, all cases have been characterized by a decreased blood supply to the head, neck, and upper extremities, with the resultant signs and symptoms of ischemia of the affected parts.

The etiology of this condition remains unknown, although various causative factors, specific and nonspecific, have been considered.17 Pathologic findings in many reports would indicate atherosclerosis3,7,8,14,21; however, others suggest that a nonspecific arteritis is the underlying cause.15 Some of the lack of agreement may arise from the fact that some reports have combined cases of isolated atherosclerotic

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