Thoracic Endovascular Aortic Repair for Chronic Aortic Dissection with an Isolated Left Vertebral Artery
- VernacularTitle:潰瘍様突出像を伴う慢性解離性大動脈瘤に対するステントグラフト内挿術時にIsolated left vertebral arteryを再建した1例
- Author:
Takuto HAYASHI
1
;
Fumitaka SUZUKI
1
;
Takuya ITO
1
;
Masatoshi SUNADA
1
;
Satoru MAEBA
1
Author Information
- Keywords: isolated left vertebral artery; aberrant vertebral artery; thoracic endovascular aortic repair; TEVAR
- From:Japanese Journal of Cardiovascular Surgery 2023;52(1):59-61
- CountryJapan
- Language:Japanese
- Abstract: Thoracic endovascular aortic repair (TEVAR) is valuable in the treatment of type B aortic dissection. An isolated left vertebral artery (ILVA) is a common anomaly of the aortic arch. The ILVA is covered during TEVAR in specific cases; however, whether the ILVA should be reconstructed in all cases remains controversial. We report a case of TEVAR performed for chronic aortic dissection in a patient with an ILVA. A 57-year-old woman with an ILVA had a type B acute aortic dissection one year prior to presentation and underwent TEVAR owing to dilation of an ulcer-like projection. We performed ILVA-left common carotid artery (LCCA) anastomosis and LCCA-left axillary artery bypass prior to TEVAR using our usual procedure. The postoperative course was favorable without any major complication. ILVA reconstruction may reduce the incidence of postoperative stroke and spinal cord injury. Usually, an ILVA is easily accessible through the supraclavicular approach, and the anatomical position of the vessel facilitates ILVA-LCCA anastomosis. ILVA reconstruction requires additional features and further consideration.
