Extracorporeal fenestration vs. laser in situ fenestration for reconstruction of the left subclavian artery in patients with aortic arch diseases
10.3760/cma.j.cn113855-20231120-00334
- VernacularTitle:体外开窗与激光原位开窗重建左锁骨下动脉的比较研究
- Author:
Jinbao QIN
1
;
Sen YANG
;
Xing ZHANG
;
Qiming WANG
;
Guang LIU
;
Xiaobing LIU
;
Weimin LI
;
Xinwu LU
Author Information
1. 上海交通大学医学院附属第九人民医院血管外科，上海 200011
- Keywords:
Aortic diseases;
Stents;
In vitro fenestration;
In situ laser fenestration;
Left subclavian artery
- From:
Chinese Journal of General Surgery
2024;39(9):681-685
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effectiveness and safety of in vitro fenestration and in situ fenestration for reconstruction of the left subclavian artery in patients with aortic arch diseases.Methods:A retrospective analysis was conducted on 80 patients with thoracic aortic dissection, aortic aneurysm, and aortic intramural hematoma involving the left subclavian artery at our center from Jan 2020 to Oct 2023.Results:Thirty-eight patients underwent in vitro fenestration to reconstruct the left subclavian artery, while 42 patients underwent in situ laser fenestration to reconstruct the left subclavian artery. The technical success rates were 97.4% and 97.6% respectively, without statistically significance ( P>0.05). Postoperative CTA examination showed that the primary rupture of the dissection was completely closed, 3 cases had type Ⅱ endoleak in vitro fenestration, and 2 cases had type Ⅱ endoleak in laser in situ fenestration. The blood flow inside the fenestration stent was fluent. During the perioperative period, one patient in the in vitro fenestration group experienced mild cerebral infarction (2.6%), one patient had mild paraplegia, and no related complications occurred in the other patients. Conclusion:For patients with aortic arch diseases, both in situ laser fenestration and in vitro fenestration are safe and effective.
