Occlusion of aortic arch branches

Occlusion of the branches of the aortic arch leads to ischemia of the brain and upper limbs. Etiology: atherosclerosis, nonspecific aorto-arteritis, compression with osteophytes, 1 rib, etc., congenital abnormalities of vessels, fibromuscular dysplasia. The main link of the pathogenesis of the disease is the hypoxia of the brain regions, blood supply to the affected artery. When one of the four arteries of the brain (internal carotid or vertebral) is affected, the blood supply of the corresponding area of ​​the brain becomes possible due to blood flow through the arterial circle of the brain (Willis circle). However, this sometimes leads to a paradoxical effect. With occlusion of the proximal part of the subclavian artery, the blood in the upper limb comes from the system of the arterial circle of the brain, impoverishing the blood supply of the latter, especially with physical exertion (subclavian steal syndrome). The most frequent localization of occlusion is bifurcation of carotid arteries (50%), less common carotid artery, brachiocephalic trunk, subclavian and vertebral arteries.