Prognostic analysis of thoracic endovascular aortic repair combined with left subclavian artery revascularization for Stanford type B aortic dissection patients with insufficient proximal landing zone
- VernacularTitle:胸主动脉腔内修复术联合左锁骨下动脉重建术治疗Stanford B型主动脉夹层患者近端锚定区不足的预后分析
- Author:
Xin HUANG
1
;
Shilin DAI
2
;
Yuqiang SHANG
2
Author Information
1. Medical School of Jianghan University, Wuhan, 430113, P. R. China
2. Department of Cardiac Surgery, The Central Hospital of Wuhan, Wuhan, 430014, P. R. China
- Publication Type:Journal Article
- Keywords:
Stanford type B aortic dissection;
endovascular repair;
left subclavian artery;
left subclavian artery revascularization technique
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(04):515-520
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical efficacy of left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection with insufficient proximal landing zone. Methods A retrospective analysis was conducted on the clinical data of patients with Stanford type B aortic dissection and insufficient proximal landing zone who underwent TEVAR combined with LSA revascularization or TEVAR alone at the Central Hospital of Wuhan from 2017 to 2021. Patients were divided into a revascularization group and a simple stent group based on the surgical approach. Perioperative data of the two groups were compared. Results A total of 144 patients were included. In the simple stent group, there were 113 patients, including 85 males and 28 females, with a median age of 56.0 (48.0, 68.0) years. In the revascularization group, there were 31 patients, including 23 males and 8 females, with a median age of 54.0 (48.2, 59.7) years. There were statistical differences in operation time, hospital stay, preoperative lesion diameter, and preoperative and postoperative right vertebral artery diameter between the two groups (P<0.05). The simple stent group had 12 (10.6%) patients of complications, which was lower than the revascularization group (9 patients, 29.0%) postoperatively. At three months postoperatively, the most common complication in the simple stent group was endoleak (5 patients), while in the revascularization group it was hoarseness (2 patients). There was no death in the two groups within 1 year postoperatively. Conclusion Both different surgical approaches have good effects on the treatment of type B aortic dissection with insufficient proximal landing zone, but further validation is needed through multicenter, large-sample, and long-term follow-up studies.
