Abstract | BACKGROUND: More evidence was required to guide the management of left subclavian artery (LSA) during thoracic endovascular aortic repair ( TEVAR). The present study aimed to compare the outcomes of LSA coverage with LSA revascularization. Another purpose of this study was to share our experience of LSA revascularization with castor single-branched stent-graft. METHODS: From January 2016 to December 2019, 134 patients with type B aortic dissection (TBAD) or intramural hematoma (IMH) were enrolled and divided into two groups, the LSA-covered group (n = 61) and the LSA-revascularized group (with castor single-branched stent-graft, n = 73). The results, such as in-hospital and 30-day mortality, stroke, paraplegia, left arm ischemia, operation time, endoleak, were compared between the two groups. RESULTS: The incidence of 30-day stroke in the LSA-covered group (8.2%) was significantly higher compared with the LSA-revascularized group (0%, P = 0.018). 30-day ischemia of left arm occurred in more patients in the LSA-covered group (11.5%, P = 0.003). No statistical difference was found in the incidences of paraplegia, endoleak, in-hospital mortality, and 30-day mortality. CONCLUSIONS: LSA should be revascularized during TEVAR to reduce the incidences of stroke and left arm ischemia. Castor single-branched stent-graft was feasible and safe for treating TBAD or IMH.
|
Authors | Changcun Fang, Chen Wang, Kai Liu, Xinyan Pang |
Journal | Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
(Ann Thorac Cardiovasc Surg)
Vol. 27
Issue 4
Pg. 251-259
(Aug 20 2021)
ISSN: 2186-1005 [Electronic] Japan |
PMID | 33342930
(Publication Type: Journal Article)
|
Topics |
- Aortic Dissection
(surgery)
- Endovascular Procedures
(methods)
- Hematoma
(surgery)
- Humans
- Stents
- Subclavian Artery
(surgery)
- Treatment Outcome
|