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01-10-2009 | Vascular-Interventional

Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

Authors: Fabrizio Fanelli, Michael D. Dake, Filippo Maria Salvatori, Armando Pucci, Giuseppe Mazzesi, Pierleone Lucatelli, Plinio Rossi, Roberto Passariello

Published in: European Radiology | Issue 10/2009

Abstract

The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70 ± 24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 8 months, for visual impairment. Type II endoleaks from excluded LSA occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required.

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Title: Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?
Authors: Fabrizio Fanelli
Michael D. Dake
Filippo Maria Salvatori
Armando Pucci
Giuseppe Mazzesi
Pierleone Lucatelli
Plinio Rossi
Roberto Passariello
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1433-3

At a glance: The STEP trials

Springer Medicine

Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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