title: Left Subclavian Arterial Coverage and Stroke During Thoracic Aortic Endografting: A Systematic Review.
abstract: Stroke is a devastating complication of thoracic endovascular aortic repair (TEVAR). Whether left subclavian artery (LSA) coverage and LSA revascularization affect stroke rate is debated. Whether patients with aneurysms or dissections undergoing TEVAR have higher stroke rates is also debated. We report a systematic review of 63 studies comprising more than 3,000 patients. We conclude that stroke risk after TEVAR is increased by LSA coverage, and that LSA revascularization reduces stroke risk. LSA revascularization may lower the rate of posterior stroke. TEVAR for aneurysm is associated with increased stroke risk compared to TEVAR for dissection.
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Waterford
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Daisy
authors.initials: D
authors.lastname: Chou
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: René
authors.initials: R
authors.lastname: Bombien
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Isil
authors.initials: I
authors.lastname: Uzun
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Aamir
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: akhoy@cshs.org.
authors.forename: Ali
authors.initials: A
authors.lastname: Khoynezhad
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications; D015607:Stents; D020521:Stroke / Q000209:etiology*; D013348:Subclavian Artery / Q000601:surgery*