Endovascular repair of complex aortic arch lesion with application of recanalize left subclaivian artery in intracavitary
10.3760/cma.j.cn112434-20200220-00054
- VernacularTitle:腔内重建左锁骨下动脉在复杂主动脉弓部病变中的应用
- Author:
Haiyang XUAN
1
;
Jianjun GE
;
Zhengchun ZHOU
;
Xiang KONG
;
Yi ZUO
;
Hailei SUN
;
Tianshu CHU
;
Jiquan YU
Author Information
1. 中国科学技术大学附属第一医院心脏外科 230001
- Keywords:
Thoracic endovascular aortic repair;
Left subclavian artery;
Chimney technique;
Branched stent;
In situ fenestration
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(6):344-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of different ways of reconstruction of left subclavian artery (LSA) in the treatment of complex aortic arch lesions.Methods:The clinical data of 34 patients with complex thoracic aortic disease undergoing intracavitary LSA reconstruction in our center from January 2019 to February 2020 were retrospectively analyzed. The distance of proximal healthy landing zone of all patients, including 29 aortic dissections involving LSA, 3 penetrating aortic ulcer and 2 thoracic aortic aneurysms, was less than 15 mm. Among them, 16 cases were treated with chimney technique, 16 cases were implanted with single branched stent-graft, 2 cases were received with left common carotid artery and LSA in situ fenestration.Results:The operation success rate of all 34 patients was 100%. One case was changed from in situ fenestration to chimney stenting. Followed up for 1-12 months, there were no death, cerebral ischemia, paraplegia and other postoperative complications. CTA review showed that the main and branch stents were in good shape, the patency rate of LSA branch stents was 100% and no endoleak occurred at 1 and 3 months after operation. The muscle strength and arterial blood pressure of bilateral upper limbs of all patients were basically the same.Conclusion:There is no consensus for the treatment of complex aortic arch lesions, so we need to customize the personalized plan and select the appropriate LSA reconstruction method in order to reduce the incidence of complications.
