Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

被引:12
作者
Fanelli, Fabrizio [1 ]
Dake, Michael D. [2 ]
Salvatori, Filippo Maria [1 ]
Pucci, Armando [1 ]
Mazzesi, Giuseppe [3 ]
Lucatelli, Pierleone [1 ]
Rossi, Plinio [1 ]
Passariello, Roberto [1 ]
机构
[1] Univ Roma La Sapienza, Dept Radiol Sci, I-00161 Rome, Italy
[2] Stanford Univ, Sch Med, Dept Cardiothorac Surg Radiol, Falk Cardiovasc Res Ctr, Stanford, CA 94305 USA
[3] Univ Roma La Sapienza, Inst Heart & Great Vessels Attilio Reale, I-00161 Rome, Italy
关键词
Aorta; Thoracic aneurysm; Stent-graft; Aortic dissection; ENDOVASCULAR REPAIR; ANEURYSMS; COVERAGE; IMPLANTATION; EXPERIENCE; RISK;
D O I
10.1007/s00330-009-1433-3
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion Of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70 +/- 24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 9 months, for Visual impairment. Type II endoleaks from excluded LSA Occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required.
引用
收藏
页码:2407 / 2415
页数:9
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