Comparison of self-radiopaque markers guiding physician-modified fenestration, chimney technique and hybrid Ⅳb technique on reconstruction of left subclavian artery in thoracic endovascular aortic repair
10.3760/cma.j.cn113855-20240417-00286
- VernacularTitle:自显影体外开窗、烟囱与Ⅳb型杂交技术在胸主动脉腔内修复术中重建左锁骨下动脉效果的对比研究
- Author:
Xiye ZHAI
1
;
Chang SHU
;
Yidan ZHANG
;
Bowen FAN
;
Hui HAN
;
Chuan TIAN
;
Kun FANG
;
Mingyao LUO
Author Information
1. 中国医学科学院北京协和医学院阜外医院血管外科中心 国家心血管病中心 心血管疾病国家重点实验室，北京 100037
- Keywords:
Aortic diseases;
Stents;
Self-radiopaque markers guiding physician-modified fenestration;
Chimney technique;
Hybrid Ⅳb technique;
Left subclavian artery
- From:
Chinese Journal of General Surgery
2024;39(9):662-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of self-radiopaque markers guiding physician-modified fenestration, chimney technique and hybrid Ⅳb technique on reconstruction of left subclavian artery (LSA) in endovascular treatment of aortic dissection (TEVAR).Methods:The clinical and follow-up data of 312 TEVAR patients treated with LSA blood supply reconstruction technology from Jan 2016 to Dec 2019 at Fuwai hospital were retrospectively analyzed.Results:There were 35 patients in the hybrid Ⅳb technique group, 93 in the chimney technique group, and 184 in the in vitro fenestration group. The follow-up period ranged from 12 to 24 months. No artificial blood vessel and stent occlusion occurred in all patients during follow-up, and the LSA blood flow was unobstructed. A total of 19 patients had endoleak by the last follow-up, and there was no statistical difference between the three groups. Eleven patients underwent reintervention surgery, all were from chimney technique group and in vitro fenestration group, with no statistical difference ( P>0.05). Severe complications occurred in 28 patients during hospitalization, and the incidence of complications was the highest in the hybrid Ⅳb technique group ( P<0.01). During follow-up, 4 patients died in the bypass group, 6 died in the external window group, and 8 died in the chimney group, with no significant difference ( P>0.05). Conclusions:The safety and efficacy of the left subclavian artery flow reconstruction by in vitro fenestration and chimney technique were similar. The occurrences of early complications were lower than that of the hybrid Ⅳb technique, but the reintervention rate of endoleak was higher.
