Innominate Artery Syndrome - An Overview

Introduction

Innominate artery syndrome, also known as brachiocephalic artery syndrome, is a condition that affects the artery present in the neck that is responsible for supplying blood to the right arm and the head. This artery is called the innominate artery, and it arises from the aorta. It is the main blood vessel that supplies blood from the heart to the other parts of the body. The innominate artery is a crucial blood vessel that provides oxygen-rich blood to the right arm, neck, and head. When this artery becomes narrow or blocked, it can lead to various symptoms and complications. The narrowing or blockage can occur for several reasons, including atherosclerosis, trauma, or a congenital anomaly.

What Are the Causes of Innominate Artery Syndrome?

Atherosclerosis is the most common cause of innominate artery syndrome. It is caused by building up of plaque, a waxy substance that forms inside the artery wall. The plaque narrows the artery, reducing blood flow to the right arm and head. Trauma to the neck, such as a car accident, can also cause damage to the innominate artery, leading to a blockage. In rare cases, innominate artery syndrome can be caused by a congenital anomaly, where the artery is abnormally shaped or positioned.

What Are the Symptoms of Innominate Artery Syndrome?

The symptoms of innominate artery syndrome depends on the severity and site of the blockage. The most common symptoms include:

• Pain or numbness in the right arm.

• Weakness or fatigue in the right arm.

• Dizziness or lightheadedness.

• Headache.

• Syncope (fainting).

• Chest pain.

• Difficulty in breathing.

• Hoarseness of voice.

• Swelling in the affected area.

How to Diagnose Innominate Artery Syndrome?

• Physical Examination: The diagnosis of innominate artery syndrome involves physical examination, imaging, and sometimes additional tests. The doctor will take the person's medical history and ask about symptoms the person may be experiencing. The doctor will do a physical examination to look for any abnormalities in a person's neck or arms, such as a weak pulse or reduced blood pressure in one arm.

• Imaging Studies: Imaging studies such as an ultrasound, a computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be ordered to get a better view of the innominate artery and the extent of the blockage. Ultrasound is a non-invasive test that is performed, and it uses sound waves to create images of the artery, while CT and MRI scans use X-rays and magnets, respectively, to produce detailed images of the blood vessels. In some cases, angiography may also be recommended to visualize the innominate artery and other blood vessels more clearly. During angiography, a contrast dye is injected into the artery, and X-ray images are taken to show the flow of blood through the vessels.

• ECG (Electrocardiogram): Other tests, such as an ECG, may also be performed to check for any abnormalities in heart function. This is because innominate artery syndrome can increase the risk of heart disease and stroke.

What Is the Treatment of Innominate Artery Syndrome?

The treatment of innominate artery syndrome depends on the severity of the blockage, the location of the affected artery, and the presence of any other underlying medical conditions.

Certains conditions can be managed with medications, such as antiplatelet agents or anticoagulants. These medications reduce the formation of blood clots and also lessen the risk of stroke and other complications. However, if the blockage is serious or causing severe symptoms, more invasive treatments may be necessary. These can include:

• Angioplasty and Stenting: This involves inserting a small balloon into the narrowed artery and inflating it to widen the opening. A stent may also be placed to keep the artery open. It is kept permanently to allow blood to flow freely.

• Endarterectomy: This is a surgical procedure that involves removing the blockage from the artery together with obstructive deposits. It is typically reserved for cases where the blockage is severe or other treatments have been unsuccessful. It is mainly performed on carotid arteries or vessels supplying the legs.

• Bypass Surgery: This involves creating a new pathway for blood flow by grafting a healthy blood vessel around the blocked area of the innominate artery. Bypass surgery improves blood flow to heart muscle.

After treatment, patients will be monitored closely to ensure that the blockage does not recur and that there are no complications. It is generally advised to go for a lifestyle change, such as quitting smoking, maintaining an optimal weight, and managing blood pressure and cholesterol levels, may also be recommended to reduce the risk of future blockages and improve overall cardiovascular health.

What Are the Complications of Innominate Artery Syndrome?

Innominate artery syndrome can lead to several complications, particularly if left untreated or poorly managed. These complications can include:

• Stroke: A blockage in the innominate artery can increase the risk of stroke, particularly if blood clots form and travel to the brain.

• Heart Disease: Innominate artery syndrome can also elevate the risk of coronary artery disease, which can further cause heart attack or other complications.

• Peripheral Artery Disease: Reduced blood flow to the arms and legs can cause peripheral artery disease, which can lead to pain, numbness, and other symptoms.

• Hoarseness and Swallowing Difficulties: If the recurrent laryngeal nerve is compressed by a narrowed or blocked innominate artery, it can cause hoarseness, difficulty speaking, and swallowing difficulties.

• Arm Swelling and Discoloration: Reduced blood flow to the right arm can cause swelling and discoloration in the affected arm.

Conclusion

Innominate artery syndrome is a rare but serious condition that can cause a range of symptoms and complications. While the underlying cause of the condition is not always clear, prompt diagnosis and treatment are important to prevent complications and improve outcomes. Treatment options may include medications, angioplasty, or surgery. It is essential to work closely with the specialist doctor so that prompt treatment plans based on personal, individual needs and medical history should be started. Additionally, managing any underlying medical conditions that may increase the risk of innominate artery syndrome can lessen the risk of developing the condition.