Efficacy of left subclavian artery revascularization strategies during thoracic endovascular aortic repair in patients with type B dissection: A single-center experience of 105 patients

Autor: Xiangyang Wu, Yongnan Li, Yinglu Zhao, Yilin Zhu, Shixiong Wang, Qi Ma, Debin Liu, Bingren Gao, Shilin Wei, Weifan Wang
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Cardiovascular Medicine, Vol 10 (2023)
Druh dokumentu: article
ISSN: 2297-055X
DOI: 10.3389/fcvm.2023.1084851
Popis: BackgroundLeft subclavian artery (LSA) revascularization during thoracic endovascular aortic repair (TEVAR) is necessary to reduce postoperative complications in patients with Stanford type B aortic dissection and an insufficient proximal anchoring area. However, the efficacy and safety of different LSA revascularization strategies remain unclear. Here, we compared these strategies to provide a clinical basis for selecting an appropriate LSA revascularization method.MethodsIn this study, we included 105 patients with type B aortic dissection who were treated using TEVAR combined with LSA reconstruction in the Second Hospital of Lanzhou University from March 2013 to 2020. They were divided into four groups according to the method used for LSA reconstruction, namely, carotid subclavian bypass (CSB; n = 41), chimney graft (CG; n = 29), single-branched stent graft (SBSG; n = 21), and physician-made fenestration (PMF; n = 14) groups. Finally, we collected and analyzed the baseline, perioperative, operative, postoperative, and follow-up data of the patients.ResultsThe treatment success rate was 100% in all the groups, and CSB + TEVAR was the most commonly used procedure in emergency settings compared with the other three procedures (P 0.05) The median follow-up time of CSB, CG, SBSG, and PMF groups was significantly different (P
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