Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Xiaohui Wang¹  Qianqian Zhu¹  Zhenjiang Li¹  Donglin Li¹  Lu Tian¹  Tao Shang¹  Yangyan He¹  Hongkun Zhang¹  Ziheng Wu¹  Peier Shen² 

[1] The First Affiliated Hospital, School of Medicine, Zhejiang University, China;The First Affiliated Hospital, School of Medicine, Zhejiang University, China;The First Affiliated Hospital, School of Medicine, Zhejiang University, China;

关键词: isolated left vertebral artery;    physician-modified fenestration;    in situ;    thoracic endovascular aortic repair;    thoracic aortic disease;   

DOI  :  10.3389/fcvm.2023.1055549

 received in 2022-09-27, accepted in 2023-03-08,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo present our experience of preserving the isolated left vertebral artery (ILVA) with physician-modified fenestration (PM-F) or in situ fenestration (ISF) during thoracic endovascular aortic repair (TEVAR) for aortic pathologies involving aortic arch.MethodsThis is a single-center, retrospective, observational cohort study. Between June 2016 and December 2021, 9 patients (8 men; median age 60.0 years old) underwent TEVAR with ILVA reconstruction (PM-F, n = 6; ISF, n = 3) were identified and analyzed.ResultsThe technical success rate was 100%. No early (<30 days) death occurred. No aortic rupture, major stroke or spinal cord injury was observed. The median follow up was 38.0 (rang: 1.0–66.0) months. One death occurred at 56 months, while the reason cannot be identified. No aortic rupture, major stroke or spinal cord injury was observed during follow up. No patient required reintervention. Out of the 22 successfully revascularized target vessels, 2 ILVAs were found occluded in 2 patients at 6 months and 7 months, respectively. However, these two patients were asymptomatic.ConclusionsOur initial experience reveals that PM-F or ISF for ILVA preservation was feasible, safe, and effective during TEVAR for complex thoracic aortic pathologies. However, the patency of preserved ILVA should be improved.

【 授权许可】

Unknown   
© 2023 Shen, Li, Wu, He, Wang, Shang, Zhu, Tian, Li and Zhang.