title: Type II Endoleaks, Left-Arm Complications, and Need of Revascularization after Left Subclavian Artery Coverage for Thoracic Aortic Aneurysms Endovascular Repair: A Systematic Review.
abstract: BACKGROUND
  The status of the left arm, the need of revascularization, and the occurrence of type II endoleakes from de left subclavian artery (LSA) after intention LSA coverage for thoracic aortic aneurysm endovascular repair need to be better understood. This systematic review was developed for contributing with such issue.
  
  
  METHODS
  Systematic literature review of studies published from January 2000 through December 2015 identified 7 studies comprising 201 patients submitted to elective endovascular repair for thoracic aortic aneurysms requiring intentional LSA coverage. Outcomes of interest included left-arm complications (ischemia, symptoms of claudication, and subclavian steal syndrome [SSS]) requiring postoperative revascularization of LSA, as well as endoleaks from the subclavian artery requiring postoperative embolization of LSA.
  
  
  RESULTS
  Left-arm complication rate was 4.5% (9 patients), requiring postoperative revascularization of LSA in 1 case (0.5%) of SSS. Type II endoleaks from the subclavian artery requiring postoperative embolization of LSA were reported in 2 cases (1.0%).
  
  
  CONCLUSIONS
  Low-quality evidence suggests very low rates of arm complications with need of LSA revascularization and of type II endoleaks requiring embolization in elective endovascular treatment of thoracic aortic aneurysms with intentional coverage of LSA without prophylactic revascularization of LSA.
authors.affiliation: Department of Vascular Surgery, School of Medicine, São Paulo University, São Paulo, SP, Brazil. Electronic address: belczak@gmail.com.
authors.forename: Sergio Quilici
authors.initials: SQ
authors.lastname: Belczak
authors.affiliation: Department of Vascular Surgery, School of Medicine, São Paulo University, São Paulo, SP, Brazil.
authors.forename: Erasmo Simão
authors.initials: ES
authors.lastname: Silva
authors.affiliation: Department of Vascular Surgery, São Camilo University, São Paulo, SP, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Klajner
authors.affiliation: Department of Vascular Surgery, School of Medicine, São Paulo University, São Paulo, SP, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
authors.affiliation: Department of Vascular Surgery, School of Medicine, São Paulo University, São Paulo, SP, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: De Luccia
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057867:Endoleak / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D012086:Reoperation; D012307:Risk Factors; D013348:Subclavian Artery / Q000601:surgery*; D013349:Subclavian Steal Syndrome / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*