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Computed tomography angiography revealed ATAAD with brachiocephalic and right subclavian artery occlusion. He underwent successful ascending aortic and arch replacement with intraoperative right brachial perfusion and forearm fasciotomy. Proximal limb function was preserved, with gradual distal motor recovery at 5\u00a0months under intensive physiotherapy. Dissection-related arterial occlusion may mimic isolated thrombosis on imaging. Prompt central aortic repair with simultaneous intraoperative limb perfusion can preserve limb viability and obviate the need for peripheral revascularization.<\/jats:p>","DOI":"10.1093\/jscr\/rjag368","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:15:48Z","timestamp":1777637748000},"source":"Crossref","is-referenced-by-count":0,"title":["Brachial artery cannulation for right upper limb ischemia secondary to acute type A aortic dissection"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6682-7670","authenticated-orcid":false,"given":"Durr","family":"Al-Hakim","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , 2775 Laurel Street, Vancouver, V5Z 1M9 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalind","family":"Groenewoud","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of British Columbia , 1081 Burrard Street, Vancouver, V6Z 1Y6 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhad","family":"Udwadia","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, University of British Columbia , 2775 Laurel Street, Vancouver, V5Z 1M9 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, University of British Columbia , 2775 Laurel Street, Vancouver, V5Z 1M9 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Moo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of British Columbia , 1081 Burrard Street, Vancouver, V6Z 1Y6 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"2026051605040821100_ref1","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.ijscr.2021.01.074","article-title":"Type A aortic dissection into brachial artery causing upper limb ischaemia: a case report","volume":"79","author":"Yong","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"2026051605040821100_ref2","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/j.jvs.2023.02.004","article-title":"Persistent malperfusion after central aortic repair in acute type I aortic dissections","volume":"77","author":"Doenges","year":"2023","journal-title":"J Vasc Surg"},{"key":"2026051605040821100_ref3","doi-asserted-by":"publisher","first-page":"33","DOI":"10.12945\/j.aorta.2017.16.034","article-title":"Cause of death following surgery for acute type A dissection","volume":"5","author":"McClure","year":"2017","journal-title":"Aorta (Stamford)"},{"key":"2026051605040821100_ref4","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/j.jvs.2012.10.079","article-title":"Management of limb ischemia in acute proximal aortic dissection","volume":"57","author":"Charlton-Ouw","year":"2013","journal-title":"J Vasc Surg"},{"key":"2026051605040821100_ref5","doi-asserted-by":"publisher","DOI":"10.52198\/21.STI.38.CV1413","article-title":"State of the art review: surgical treatment of acute type A aortic dissection","volume":"38","author":"Pitts","year":"2021","journal-title":"Surg Technol Int"},{"key":"2026051605040821100_ref6","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.ejvssr.2018.05.011","article-title":"Management of lower extremity ischaemia during type A dissection repair","volume":"39","author":"Howe","year":"2018","journal-title":"EJVES Short Rep"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/5\/rjag368\/68295906\/rjag368.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/5\/rjag368\/68295906\/rjag368.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:04:11Z","timestamp":1778922251000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag368\/8679222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":6,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag368","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,5,1]]},"article-number":"rjag368"}}