title: [Treatment of left subclavian artery in endovascular repair of thoracic aortic aneurysm and thoracic aortic dissection].
abstract: OBJECTIVE
  To investigate the treatments of left subclavian artery (LSA) in endovascular repair (EVR) of thoracic aortic aneurysm (TAA) and thoracic aortic dissection (TAD).
  
  
  METHODS
  In 54 TAD or TAA cases, all of the proximal landing zone (PLZ) were less than 15 mm and only the LSA was needed to be treated in EVR, the following methods and techniques were used in the treatments of LSA: complete cover, partial cover, endovascular reconstruction following complete cover, surgical reconstruction before complete cover.
  
  
  RESULTS
  DSA was used to evaluate the condition of cerebral circulation in all cases. Forty left subclavian arteries were covered completely. Ten were covered completely after right subclavian artery (RSA)-LSA or left common carotid artery (LCCA)-LSA bypass. PTA and stent in LSA was done in 3 cases. In 1 case, LSA was covered completely first, and then the graft was punctured and bare stent was fixed after inflation by cutting balloon. All of the ancillary techniques were enforced successfully. No severe complications were found in brain and upper extremity. The proximal endoleak rate was 17% (9/54). In the 40 cases whose LSA were not reconstructed, the primary left subclavian steal syndrome (LSSS) happened in 8 cases (20%) and the primary average systolic pressure of left brachial artery was 63 +/- 24 mm Hg.
  
  
  CONCLUSIONS
  EVR can be enforced safely and efficiently in TAA and TAD with short PLZ by some ancillary endovascular or surgical techniques. The methods to treat the LSA depend on the condition of the cerebral circulation.
authors.affiliation: Department of Vascular Surgery, the General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Dai-hua
authors.initials: DH
authors.lastname: Yang
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Liu
authors.forename: Guo-hua
authors.initials: GH
authors.lastname: Zhang
authors.forename: Fa-qi
authors.initials: FQ
authors.lastname: Liang
authors.forename: Lu-yue
authors.initials: LY
authors.lastname: Gai
authors.forename: Tai
authors.initials: T
authors.lastname: Yin
authors.forename: Xin
authors.initials: X
authors.lastname: Jia
authors.forename: Hong-peng
authors.initials: HP
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery*