A comparative study between pre fenestration and left common carotid-left subclavian artery bypass for reconstruction of left subclavian artery in Stanford B aortic dissection patients undergoing thoracic endovascular repair
10.3760/cma.j.cn113855-20231225-00437
- VernacularTitle:预开窗与左颈动脉-锁骨下动脉转流术在Stanford B型主动脉夹层腔内修复中重建左锁骨下动脉疗效的对比分析
- Author:
Qingpeng SONG
1
;
Maohua WANG
1
;
Xuejun WU
1
Author Information
1. 山东第一医科大学附属省立医院血管外科，济南 250021
- Publication Type:Journal Article
- Keywords:
Aortic diseases;
Stents;
Left subclavian artery;
Pre fenestration;
Left common carotid-left subclavian artery;
Thoracic endovascular aortic repair
- From:
Chinese Journal of General Surgery
2025;40(5):381-385
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of pre fenestration vs left common carotid-left subclavian artery(LCCA-LSA) bypass for left subclavian artery (LSA) reconstruction in Stanford B aortic dissection patients undergoing thoracic endovascular repair(TEVAR).Methods:The clinical and follow-up data of 120 patients with Stanford type B aortic dissection who were treated with TEVAR and reconstructed by pre fenestration or LCCA-LSA bypass from Jul 2009 to Aug 2023 at the Department of Vascular surgery of Provincial Hospital, Shandong First Medical University were analyzed retrospectively.Results:Patients were retrospectively divided into pre fenestration group (40 cases) and hybrid repair (bypass) group (80 cases). The average operation time [(146.9±37.6) vs.(332.4±106.2)min, P<0.001] and hospital stay [(15.8±5.6) vs. (22.9±9.0)d P<0.001] in the pre fenestration group were lower than those in the hybrid repair group, and the preoperative complications in the pre fenestration group were slightly higher than that in hybrid repair group (97.5% vs. 91.3%). One patient in the pre fenestration group failed the surgery, and the technical success rate was 97.5%. The postoperative complications in the pre fenestration group were lower than hybrid repair group (22.5% vs. 26.3%). There was one experiencing secondary intervention in the pre fenestration group and 6 in the hybrid repair group. Two patients died postoperatively, all in hybrid repair group. Conclusion:Both pre fenestration and left common carotid-left subclavian artery(LCCA-LSA) bypass(hybrid procedure) are safe and feasible methods for reconstruction of LSA in Stanford B aortic dissection patients undergoing TEVAR.
