Intentional Occlusion of the Left Subclavian Artery during Endovascular Repair of Descending Thoracic Aorta

Hernán G. Bertoni, Fabián A. Azzari, Germán A. Girela, Gustavo A. Salvo, Alejandro De la Vega, Gonzalo A. Romero, Natalia Bourques, Adrián Charask, Jorge H. Leguizamón

Abstract


SUMMARY

The safety and efficacy of endovascular repair of descending thoracic aorta depends on certain anatomical conditions, in particular the presence of a healthy segment of the aorta (proximal neck). In a significant proportion of patients, the proximal neck is inadequate or non-existent. A bypass or transposition of the left subclavian artery would maintain an adequate perfusion of the left arm after stent-graft implantation. However, this surgical approach is not always feasible in unstable patients who are treated urgently or that have multiple comorbidities.

Objective

Evaluate the clinical and neurological consequences of intentional occlusion of the left subclavian artery during endovascular repair of descending thoracic aorta.

Material and Methods

Between August 1999 and February 2010, 136 patients were consecutively treated with implantation of self-expandable stent-grafts. In 29 patients (21%) with absence of an adequate proximal neck (healthy aorta sector ≥ 15mm in length), it had to be intentionally covered the origin of the left subclavian artery. In all cases, before procedure it was carried out a selective angiography of the right vertebral artery in order to confirm the permeability of this and the conformation of the vertebrobasilar circulation.

 

 

 

Background


Full Text

Refbacks

  • There are currently no refbacks.


Licencia Creative Commons
The documents published in this journal are under the licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.

Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar