Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2021 , Vol 30 , Issue 3
Long-term results of left subclavian artery coverage during thoracic endovascular aortic repair: A single center study
Kemal Karaarslan1, Ayşe Gül Kunt1, Onur Saydam2, Deniz Şerefli3, Burçin Abud1
1Department of Cardiovascular Surgery, Health Sciences University, Tepecik Traning and Research Hospital, Izmir, Turkey
2Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
3Department of Cardiovascular Surgery, Başkent University Faculty of Medicine, Ankara Turkey
DOI : 10.9739/tjvs.2021.1037 Objectives: In this study, we aimed to evaluate the results of patients with or without left subclavian artery (LSA) coverage during thoracic endovascular aortic repair (TEVAR) in terms of type IA endoleak.

Patients and methods: Between December 2011 and March 2020, a total of 50 patients (42 males, 8 females; mean age: 65.2±12.0 years; range, 53.2 to 77.2 years) who underwent TEVAR in our clinic were retrospectively analyzed. The patients were divided into two groups Group 1 (n=34) including patients whose LSA was not covered and Group 2 (n=16) whose LSA was covered by an endograft during the procedure. Primary outcome measures were all-cause mortality and type IA endoleak.

Results: Indications were mostly type B aortic dissection (n=15, 30%) (Group 1 n=7, Group 2 n=8) and descending thoracic aortic aneurysms (n=15, 28%) (Group 1 n=11, Group 2 n=4) (p=0.605). The mean follow-up for all patients was 18±12.2 months (p=0.26). Overall mortality was 10% (5/50) and all were in Group 1 (n=5/0), indicating no statistically significant difference between the groups (p=0.11). During follow-up, type IA leak was detected in five patients and was found to be more frequent in Group 2 (n=1/4) (p=0.02). None of the patients had a cerebrovascular accident and spinal cord ischemia during follow-up.

Conclusion: The coverage of the LSA during TEVAR may pose a risk for type IA leakage. Left-arm ischemia can be treated with carotid-subclavian bypass surgery after LSA occlusion. Keywords : Left subclavian artery, mortality, thoracic endovascular aortic repair, type IA endoleak

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