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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What Is Brachiocephalic Arterial Insufficiency?
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:
- Atherosclerosis, or plaque buildup in the artery.
- Diabetes.
- High blood pressure.
- High cholesterol.
Brachiocephalic arterial insufficiency risk factors
Certain risk factors may predispose people to brachial arterial insufficiency.
These risk factors include:
- Age – the older you are, the higher the risk.
- Genetics and family history of the condition.
- Hypertension – high blood pressure.
- Hyperlipidemia – high cholesterol.
- Smoking – self-explanatory.
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:
- Cardioembolic conditions – such as atrial fibrillation.
- Infective endocarditis – a heart infection.
- Systemic hypercoagulable states – also known as thrombophilia, which causes blood to clot more than normal.
- Vertebral artery dissection – a tear in the lining of the vertebral artery, located in the neck, that supplies blood to the brain.
How common is brachiocephalic arterial insufficiency?
Brachiocephalic arterial insufficiency is uncommon. Both men and women have the same amount of risk.
What Are the Signs and Symptoms of Brachiocephalic Arterial Insufficiency?
People with brachiocephalic arterial insufficiency may experience symptoms such as:
- Numbness, tingling, or weakness in the right arm.
- Pain in the right arm.
- Stroke-like symptoms, including vision changes and facial drooping.
- Transient ischemic attacks (TIAs) or mini-strokes.
When should I see a doctor about my brachiocephalic arterial insufficiency symptoms?
If you have any stroke-like symptoms, call 911 immediately. Respond FAST to stroke symptoms by remembering:
- Face weakness — Can the person smile?
- Arm weakness — Can the person raise both arms?
- Speech problems — Can the person speak clearly and understand what you say?
- Time to call 911 — If you see any of these signs.
How Do You Diagnose Brachiocephalic Arterial Insufficiency?
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.
How Do You Treat Brachiocephalic Arterial Insufficiency?
Brachiocephalic arterial insufficiency can be treated through lifestyle changes, medication, and surgery.
Lifestyle changes
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:
- Avoiding tobacco use.
- Eating a healthy diet.
- Exercising regularly.
Medications
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.
Surgical Treatment
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.
Risks of surgery
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.
Why Choose UPMC for Brachiocephalic Arterial Insufficiency Care?
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.
When you choose UPMC, you’ll have access to:
- Advanced, minimally invasive surgical interventions and groundbreaking clinical trials.
- A multidisciplinary team of experts that provide specialized care for aortic disease across the lifespan.
- Support and resources through our partnership with patient advocacy organizations, such as the Marfan Foundation, which aim to improve the lives of people with familial and genetically mediated aortic disease.
