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AI InsightLeft-arm ischemia can be treated with carotid-subclavian bypass surgery after LSA occlusion.
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Özet
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.