Synchronous arch arterial occlusion - A clinical impasse?

Synchronous athero-thrombotic obliteration of both the right brachio-cephalic and left subclavian arteries occurred in a single patient.

• The patient was a hypertensive male.
• The patient had been symptomatic for only 6 hours at presentation.
• This represents an uncommon case of simultaneous occlusion of two aortic arch arteries.
• The pathogenetic mechanism involved was athero-thrombotic obliteration.

Peripheral artery disease involving aortic arch arteries can present with synchronous luminal stenosis or obliteration of multiple vessels.

• Peripheral artery disease is described as an extra-cardiac manifestation of atherosclerosis.
• Clinical presentation of peripheral artery disease is typically equated to lower limb ischemia.
• A similar pathogenetic mechanism plays a role in luminal stenosis or obliteration of one or more of the aortic arch arteries.
• This case demonstrates that multiple aortic arch arteries can be simultaneously affected.