Aortic Arch Syndrome

Arteriosclerotic occlusion of the great vessels arising from the aortic arch was initially described by Savory¹ in 1856. Hunt,² in 1914, pointed out that extracranial obstruction of the carotid arteries could cause stroke. Introduction of arteriographic techniques by Egas-Moniz et al³ in 1937 made accurate diagnosis of these lesions possible. Davis et al⁴ are given credit for first surgically correcting occlusive disease in arteries at their origin from the aortic arch.

In 1960, Contorni⁵ demonstrated angiographically reversal of blood-flow in the ipsilateral vertebral artery in an asymptomatic patient with occlusion of the first portion of the subclavian and an absent pulse. Reivich et al,⁶ in 1961, observed a similar phenomenon in two patients who were operated on because of symptoms related to basilar artery insufficiency. In a series of animal experiments, they were able to duplicate and quantitate such reversal of cerebral blood flow.