[Prospective study of coverage of left subclavian artery during thoracic endovascular aortic repair in a single center].
OBJECTIVE
To describe observation of security and availability of covering left subclavian artery during thoracic endovascular aortic repair (TEVAR) in follow-up.


METHODS
From December 2007 to December 2008, 111 consecutive patients received stent grafts to treat lesions involving thoracic aorta. According to the covering of left subclavian artery, four groups including total covering (TC), less-than 50% covering (LTC), more-than 50% covering (MTC) and non-covering (NC) were formed. Difference of blood pressure between two upper extremities was required before TEVAR and 1st, 3rd, 5th, 30th day after TEVAR. Patients were evaluated postoperatively and at follow-up for stroke as well as symptoms of paraplegia, hemiparalysis or left upper extremity claudication.


RESULTS
Fifty-five (49.6%), 18 (16.2%), 7 (6.3%) and 31 (27.9%) cases were divided into TC, LTC, MTC and NC groups, respectively. Difference of blood pressure between TC and the 3 latter groups were significantly different (P<0.01). Complications appeared as followed during one week after TEVAR: 13 patients in dizziness, among which 5 patients suffered from amaurosis and spotted vision, and 7 patients in left upper extremity claudication. No stroke, paraplegia or hemiparalysis in TC. Thoracic aortic lesions were successfully excluded in all patients.


CONCLUSIONS
Intentional coverage of left subclavian artery to obtain an adequate proximal landing zone during TEVAR is safe and well-tolerated. But it may be managed expectantly with some exceptions for further lasting efficacy.
Si
Yi
Y
Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Fu
Wei-guo
WG
Wang
Yu-qi
YQ
Xu
Xin
X
Guo
Da-qiao
DQ
Chen
Bin
B
Jiang
Jun-hao
JH
Yang
Jue
J
Shi
Zhen-yu
ZY
Zhu
Ting
T
Shi
Yun
Y
Dong
Zhi-hui
ZH
D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery*; D016896:Treatment Outcome