دورية أكاديمية
Management of the vertebral artery during thoracic endovascular aortic repair with coverage of the left subclavian artery.
| العنوان: | Management of the vertebral artery during thoracic endovascular aortic repair with coverage of the left subclavian artery. |
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| المؤلفون: | Zhu J; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China., Xi EP; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China., Zhu SB; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China., Yin GL; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China., Wang RP; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China., Zhang Y; Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of the People's Liberation Army, Wuhan 430070, China. |
| المصدر: | Journal of thoracic disease [J Thorac Dis] 2017 May; Vol. 9 (5), pp. 1273-1280. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101533916 Publication Model: Print Cited Medium: Print ISSN: 2072-1439 (Print) Linking ISSN: 20721439 NLM ISO Abbreviation: J Thorac Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: Hong Kong : AME Publishing Company Original Publication: Hong Kong : Pioneer Bioscience Pub. Co. |
| مستخلص: | Background: The application of thoracic endovascular aortic repair (TEVAR), a minimally invasive operation, in the aortic arch has been a challenge of cardiovascular surgery in recent years. This study aimed to investigate management of the vertebral artery with coverage of the left subclavian artery (LSA) during TEVAR. Methods: From January 2007 to September 2014 in the Department of Cardiothoracic Surgery at Wuhan General Hospital of Guangzhou Military Region, 160 patients underwent LSA closure or partial coverage during TEVAR of an aortic lesion near the LSA. The vertebral artery treatment, the reason for the surgical approach selection, and the prognosis were analyzed. Results: In 94 patients with partial LSA coverage during TEVAR, no treatment was provided for the vertebral arteries, revealing blood flow of the left vertebral artery forward into the skull after surgery. For 66 patients with full LSA coverage (closure) during TEVAR, right carotid artery-left common carotid artery bypass surgery was performed before TEVAR in ten patients, without any treatment for the vertebral artery, showing reverse blood flow of the left vertebral artery after surgery. Left common carotid artery-LSA bypass surgery was performed before TEVAR in four patients; right common carotid artery-left common carotid artery-LSA bypass surgery was performed before TEVAR in three cases, and 6 out of these 7 patients underwent proximal LSA ligation, showing no obvious blood flow in the left vertebral artery. The closure of the LSA aortic arch opening using an occluder was performed in one patient, preserving the forward blood flow in the left vertebral artery. Among the 160 patients in this study, postoperative recurrent laryngeal nerve injury occurred in one patient after right common carotid artery-left common carotid artery-LSA bypass surgery, and the remaining 159 patients had no significant severe complications or death within 1 postoperative month. Conclusions: Appropriate management of the aortic arch branch vessels may expand the application of TEVAR to the aortic arch and reduce complications, especially for high-risk patients who have a difficult time tolerating thoracotomy. Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare. |
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| فهرسة مساهمة: | Keywords: Aortic dissection; aortic arch; endovascular repair; left subclavian artery (LSA); vertebral artery |
| تواريخ الأحداث: | Date Created: 20170616 Latest Revision: 20201001 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC5465137 |
| DOI: | 10.21037/jtd.2017.04.27 |
| PMID: | 28616278 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2072-1439 |
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| DOI: | 10.21037/jtd.2017.04.27 |