title: A custom-made scalloped stentgraft to preserve left subclavian artery flow in descending thoracic aortic disease with a short neck.
abstract: In thoracic stentgrafting, a short proximal landing zone may necessitate intentional occlusion of the left subclavian artery, which may lead to brain, spinal cord, and left arm malperfusion. A scalloped stentgraft is designed for adequate proximal sealing and preserving the left subclavian artery flow. We performed a systematic review, describe the required pre-operative planning and details of the perioperative technique used and report our own experience. In literature, only 29 patients were reported so far using a proximal scalloped stentgraft. Results show a high technical success rate and low complication rate. These results are comparable to the results from our own institution. From these first small series the scalloped thoracic endovascular aortic repair appears to be a safe and relatively simple solution for thoracic aortic disease involving the left subclavian artery.
authors.affiliation: a Department of Cardiothoracic Surgery , St. Antonius Hospital , Nieuwegein , The Netherlands.
authors.forename: Emma
authors.initials: E
authors.lastname: Van Der Weijde
authors.affiliation: a Department of Cardiothoracic Surgery , St. Antonius Hospital , Nieuwegein , The Netherlands.|b Department of Vascular & Endovascular Surgery , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Olaf J
authors.initials: OJ
authors.lastname: Bakker
authors.affiliation: a Department of Cardiothoracic Surgery , St. Antonius Hospital , Nieuwegein , The Netherlands.
authors.forename: Robin H
authors.initials: RH
authors.lastname: Heijmen
mesh_terms: D001013:Aorta, Thoracic / Q000503:physiopathology* / Q000601:surgery*; D001018:Aortic Diseases / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012039:Regional Blood Flow; D015607:Stents; D013348:Subclavian Artery / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Aortic disease; TEVAR; left subclavian artery; operative technique; scallop