期刊
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY
卷 27, 期 4, 页码 251-259出版社
MEDICAL TRIBUNE INC
DOI: 10.5761/atcs.oa.20-00166
关键词
castor single-branched stent-graft; left subclavian artery; thoracic endovascular aortic repair
资金
- National Natural Science Foundation of China [81600293]
- Key Research and Development project of Shandong Province [2018GSF121007]
The study suggests that left subclavian artery revascularization during thoracic endovascular aortic repair (TEVAR) is crucial to reduce the risks of stroke and left arm ischemia. Castor single-branched stent-graft is a feasible and safe option for treating type B aortic dissection or intramural hematoma.
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.
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