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• W3111339000 abstract "Introduction Esophageal compression due to vascular anomalies is well known since Bayford's description of dysphagia lusoria in 1787. This condition is due to an aberrant origin of the right subclavian artery and is the most common vascular variation associated with symptomatic esophageal compression. Other vascular anomalies can also lead to dysphagia being extremely uncommon. Objectives We present two clinical cases of different vascular anomalies with consequent symptomatic pharyngeal or esophageal compression. Materials and Methods The clinical process of two patients with dysphagia associated with vascular anomalies was reviewed. Clinical and iconographic data were collected. Results A 77-year-old man, with multiple vascular risk factors, with a history of atrial fibrillation, had been followed for a descending thoracic aortic aneurysm. The last computed tomography angiography (CTA) performed showed a descending thoracic aorta diameter of 42mm. Two years after this last control, the patient starts complaints of gradual worsening dysphagia predominantly for solids. Clinical investigation did not reveal a defined etiology. Thus, the patient repeated the CTA, which revealed the presence of a penetrating aortic ulcer in the medial portion of the aortic arch, about 18 mm deep, conditioning marked compression of the adjacent trachea and esophagus (fig 1). The patient was proposed to perform a hybrid treatment with TEVAR plus surgical de- -branching of the aortic arch using a carotid-carotid and a carotid-subclavian bypass. A 62-year-old woman with a history of obesity and epilepsy, presents with dysphagia mainly for solids with several months of evolution and occasional episodes of choking. After the most common causes have been excluded, a CTA of the cervical and thoracic region was performed, which revealed the presence of a left internal carotid artery kinking with marked pharyngeal compression (fig 2). Bearing in mind that the complaints conditioned her a marked reduction in the quality of life, surgical correction was proposed. The patient underwent vascular reconstruction surgery with excision of the redundant segment of the internal carotid artery and direct end-to-end anastomosis. The patient showed a marked improvement in quality of life. At the follow-up, 14 days after the procedure, she no longer had symptoms of dysphagia. Conclusions Overall, vascular anomalies are very rare causes of dysphagia, and are often diagnosed in imaging studies after the most common causes have been excluded. When compressive symptoms condition a significant impact in quality of lie, invasive treatment should be considered, however the therapeutic decision must be individualized." @default.
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• W3111339000 date "2020-10-01" @default.
• W3111339000 modified "2023-09-23" @default.
• W3111339000 title "Symptomatic Pharyngoesophageal Compression Due To Vascular Anomalies: A Report Of Two Rare Cases." @default.
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