Analysis of thoracic endovascular aortic repair in 29 cases with insufficient proximal landing zone
- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 11
- DOI:
- 10.3760/cma.j.issn.1673-4777.2011.11.003
- Key Word:
- 主动脉;支架;锁骨下动脉;近端锚定区;Aortic;Thoracic endovascular aortic repair;Subclavian artery;Proximal landing zone
Abstract： Objective To discuss the strategies for management of insufficient proximal landing zone during thoracic endovascular aortic repair(TEVAR).Methods We retrospectively investigated the outcomes and complications after the TEVAR in 29 patients of thoracic aortic cases with short proximal anchoring area( 16 aortic dissections,1 aortic pseudoaneurysms,8 aortic aneurysms,4 penetrating ulcer) between 2009 and 2011.The endoleak,left subclavian artery(LSA) developing,left upper limb symptom and other results were evaluated after operation.Results Technical success were achieved in all cases(8 intentional coverage of the LSA,15 “chimey operation”,6 hybrid operation).Two patients happened type 1 endoleak.Two patients with complete LSA coverage had mild clinical symptoms.4 patients had dizziness.One patient had excessive blood loss,and one patient had anastomotic fistula.Conclusion Intentional LSA coverage can expand the applicability of TEVAR with high tolerability.However,intentional LSA coverage with “Chimney operation” or hybrid operation was needed when the patient had advantage of the left vertebral artery.They can be especially used for patients with left vertebral artery blood supply dominance or with cerebral infarction and other brain blood supply diseases.
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