In Situ Fenestration and Carotid-Subclavian Bypass for Left Subclavian Artery Revascularization During Thoracic Endovascular Aortic Repair

被引:5
作者
Fan, Bowen [1 ]
Fang, Kun [1 ]
Tian, Chuan [1 ]
Fang, Jie [1 ]
Chen, Dong [1 ]
Zhao, Jiawei [1 ]
Luo, Mingyao [1 ,3 ,4 ]
Shu, Chang [1 ,2 ,3 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Ctr Vasc Surg, Ctr Vasc Dis,State Key Lab Cardiovasc Dis, Beijing 100037, Peoples R China
[2] Cent South Univ, Xiangya Hosp 2, Dept Vasc Surg, Changsha 410011, Peoples R China
[3] Zhengzhou Univ, Fuwai Cent China Hosp, Cent China Branch Natl Ctr Cardiovasc Dis, Henan Cardiovasc Dis Ctr,Cent China Fuwai Hosp,Dep, Zhengzhou 450046, Peoples R China
[4] Kunming Med Univ, Fuwai Yunnan Cardiovasc Hosp, Dept Vasc Surg, Affiliated Cardiovasc Hosp, Kunming 650102, Peoples R China
基金
中国国家自然科学基金;
关键词
Aortic arch; Thoracic endovascular aortic repair; Thoracic stent-graft; Carotid-subclavian bypass; In situ needle fenestration; STENT-GRAFT FENESTRATION; ARCH REPAIR; OUTCOMES; DISSECTION; CHIMNEY;
D O I
10.1007/s00270-024-03675-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
PurposeTo evaluate the safety and feasibility of left subclavian artery (LSA) revascularization techniques during thoracic endovascular aortic repair (TEVAR)-the in situ needle fenestration (ISNF) technique and the carotid-subclavian bypass (CS-Bp)-for complicated aortic pathologies.MethodsA retrospective single-center observational study was conducted to identify all patients with thoracic aortic pathologies who underwent TEVAR with LSA revascularization using either CS-Bp or ISNFs from January 2014 to December 2020.ResultsOne hundred and twelve consecutive patients who received TEVAR with LSA revascularization were included. Among them, 69 received CS-Bp and 43 received ISNF (29 using the Futhrough adjustable puncture needles, 14 using the binding stent-graft puncture systems). Technical success, defined as achieving aortic arch pathology exclusion and LSA preservation, was attained in 99.1% patients. Early mortality was 0.9%. Major adverse events within 30 days, including one cerebral hemorrhage, one cervical incision hemorrhage, one stroke and two paraplegia, were exclusively observed in the CS-Bp group. Immediate type I, II and III endoleaks occurred in 0%, 4.7% and 2.3% in the ISNF group, respectively, compared to 0%, 2.9% and 0% in the CS-Bp group.One hundred and eight (97.2%) patients were available for follow-up at a median 50 (maiximum of 103) months, revealing a LSA patency rates of 99.1%. Six patients died during follow-ups-five in the CS-Bp group and one in the ISNF group. Cause of death include one aortic-related stent-graft infection, three non-related and two with unknow causes. The survival exhibited no significantly different between the ISNF (97.7%) and CS-Bp (89.9%) groups (p = 0.22).ConclusionsBoth CS-Bp and ISNF are feasible techniques for LSA reconstruction in TEVAR. ISNF, whether using Futhrough or BPS, seems to be competitive with CS-Bp.
引用
收藏
页码:717 / 727
页数:11
相关论文
共 28 条
  • [1] [Anonymous], 2014, Circ Cardiovasc Interv, DOI DOI 10.1016/J.JVS.2013.12.008
  • [2] Physician-Modified Thoracic Stent-Grafts for the Treatment of Aortic Arch Lesions
    Canaud, Ludovic
    Baba, Toshio
    Gandet, Thomas
    Narayama, Kouhei
    Ozdemir, Baris Ata
    Shibata, Tsuyoshi
    Alric, Pierre
    Morishita, Kiyofumi
    [J]. JOURNAL OF ENDOVASCULAR THERAPY, 2017, 24 (04) : 542 - 548
  • [3] Clinical outcomes and material properties of in situ fenestration of endovascular stent grafts
    Crawford, Sean A.
    Sanford, Ryan M.
    Forbes, Thomas L.
    Amon, Cristina H.
    Doyle, Matthew G.
    [J]. JOURNAL OF VASCULAR SURGERY, 2016, 64 (01) : 244 - 250
  • [4] Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS)
    Czerny, Martin
    Schmidli, Jurg
    Adler, Sabine
    van den Berg, Jos C.
    Bertoglio, Luca
    Carrel, Thierry
    Chiesa, Roberto
    Clough, Rachel E.
    Eberle, Balthasar
    Etz, Christian
    Grabenwoeger, Martin
    Haulon, Stephan
    Jakob, Heinz
    Kari, Fabian A.
    Mestres, Carlos A.
    Pacini, Davide
    Resch, Timothy
    Rylski, Bartosz
    Schoenhoff, Florian
    Shrestha, Malakh
    von Tengg-Kobligk, Hendrik
    Tsagakis, Konstantinos
    Wyss, Thomas R.
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2019, 55 (01) : 133 - 162
  • [5] Perioperative Outcomes of Carotid-Subclavian Bypass or Transposition versus Endovascular Techniques for Left Subclavian Artery Revascularization during Nontraumatic Zone 2 Thoracic Endovascular Aortic Repair in the Vascular Quality Initiative
    D'Oria, Mario
    Karkkainen, Jussi M.
    Tenorio, Emanuel R.
    Oderich, Gustavo S.
    Mendes, Bernardo C.
    Shuja, Fahad
    Colglazier, Jill
    DeMartino, Randall R.
    [J]. ANNALS OF VASCULAR SURGERY, 2020, 69 : 17 - 26
  • [6] Contemporary comparison of aortic arch repair by endovascular and open surgical reconstructions
    De Rango, Paola
    Ferrer, Ciro
    Coscarella, Carlo
    Musumeci, Francesco
    Verzini, Fabio
    Pogany, Gabriele
    Montalto, Andrea
    Cao, Piergiorgio
    [J]. JOURNAL OF VASCULAR SURGERY, 2015, 61 (02) : 339 - 346
  • [7] Erbel Raimund, 2014, Kardiol Pol, V72, P1169, DOI 10.5603/KP.2014.0225
  • [8] Extra-Thoracic Supra-aortic Bypass Surgery Is Safe in Thoracic Endovascular Aortic Repair and Arterial Occlusive Disease Treatment
    Gombert, Alexander
    van Issum, Lea
    Barbati, Mohammad E.
    Grommes, Jochen
    Keszei, Ndras
    Kotelis, Drosos
    Jalaie, Houman
    Greiner, Andreas
    Jacobs, Michael J.
    Kalder, Johannes
    [J]. EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2018, 55 (06) : 861 - 866
  • [9] An Experimental Study of Laser in situ Fenestration of Current Aortic Endografts
    Jayet, J.
    Heim, F.
    Coggia, M.
    Chakfe, N.
    Coscas, R.
    [J]. EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2018, 56 (01) : 68 - 77
  • [10] Long-term durability of aortic arch in situ stent graft fenestration requiring lifelong surveillance
    Kasprzak, Piotr M.
    Kobuch, Reinhard
    Schmid, Christof
    Kopp, Reinhard
    [J]. JOURNAL OF VASCULAR SURGERY, 2017, 65 (02) : 538 - 541