Brachiocephalic arterial insufficiency is a rare condition in which the brachiocephalic artery is narrowed or blocked. This condition prevents proper blood flow to the upper right quadrant of the body. It can be caused by high blood pressure, diabetes, high cholesterol, and atherosclerosis.
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The brachiocephalic artery is the first of the three great vessels of the aortic arch coming off the aorta, the largest artery in the body. It plays a vital role in moving oxygenated blood from the heart to the upper right half of the body and brain.
The brachiocephalic artery also is referred to as the brachiocephalic trunk or innominate artery. This artery runs along the right side of your chest. It goes on to form the right subclavian artery, which provides blood to the upper right side of the trunk, and the right common carotid artery, which is the main artery providing blood to the neck and head.
Brachiocephalic arterial insufficiency occurs when this artery is narrowed or blocked, causing a lack of blood flow to the upper right side of the body. Some people are born with variations in this artery, which can lead to other malformations that may compress the trachea and/or esophagus.
What causes brachiocephalic arterial insufficiency?
There are various causes of brachiocephalic arterial insufficiency, including:
Certain risk factors may predispose people to brachial arterial insufficiency.
These risk factors include:
Also at increased risk are people who have a history of arterial diseases, which affect the vessels that carry oxygen-rich blood away from the heart, including:
Other health conditions and injuries may increase your risk of developing blood clots, which can lead to brachiocephalic arterial insufficiency.
Contributing factors include a history of:
Brachiocephalic arterial insufficiency is uncommon. Both men and women have the same amount of risk.
People with brachiocephalic arterial insufficiency may experience symptoms such as:
If you have any stroke-like symptoms, call 911 immediately. Respond FAST to stroke symptoms by remembering:
Brachiocephalic arterial insufficiency is typically diagnosed during a physical exam when your pulse and blood pressure are taken. These readings can indicate issues like blockages.
An ultrasound or CT scan can provide a more in-depth look at the blood vessels in the chest to diagnose this condition.
Brachiocephalic arterial insufficiency can be treated through lifestyle changes, medication, and surgery.
Your doctor will work with you to implement certain lifestyle changes to improve your symptoms.
These recommended changes include improving your overall heart health by:
Taking medication to control blood pressure and cholesterol levels can help manage this condition. Additionally, aspirin and blood thinners can improve symptoms and increase blood flow to the brain and right arm.
In some cases, surgical intervention is necessary.
Severe cases of brachiocephalic arterial insufficiency may require a surgical bypass to clear the blocked area of the artery. The bypass procedure redirects the blood and allows it to flow around the blockage.
We offer minimally invasive procedures and traditional surgeries to treat brachiocephalic arterial insufficiency.
Our experts perform endovascular angiograms to visualize and treat blockages in the brachiocephalic artery. This condition may be treated with catheter-delivered balloon dilation, followed by stent placement into the artery or stent placement alone. Once the stent is placed and deployed, the blood should flow properly.
One rare but significant risk of innominate artery surgery is the formation of a fistula, or hole, in the trachea and the brachiocephalic artery. This unusual condition primarily affects people who have had brachiocephalic arterial surgery and a tracheostomy, but it can lead to severe illness and death.
At UPMC, our team of experts has extensive experience treating a wide range of conditions affecting the aorta. Our center takes a multidisciplinary approach to aortic care with experts collaborating across specialties, including congenital heart disease care, cardiac surgery, and vascular surgery.
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Last reviewed by a UPMC medical professional on 2024-11-14.
