Intentional Left Subclavian Artery Occlusion by Thoracic Aortic Stent-Grafts without Surgical Transposition

2001 ◽  
Vol 8 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Klaus A. Hausegger ◽  
Peter Oberwalder ◽  
Kurt Tiesenhausen ◽  
Josef Tauss ◽  
Olaf Stanger ◽  
...  
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Case Reports ◽  
Artery Occlusion ◽  
Left Vertebral Artery ◽  
Stent Grafts ◽  
Subclavian Artery Occlusion ◽  
Limited Experience ◽  
Type B Dissection

Purpose: To report the consequences of endoluminal deployment of stent-grafts in the thoracic aorta with intentional occlusion of the left subclavian artery. Case Reports: Three patients with an aortic type-B dissection and 1 with a thoracic aneurysm were treated endoluminally with Talent stent-grafts implanted over the ostium of the left subclavian artery without prior surgical subclavian-carotid transposition. The primary intimal tears were sealed and the degenerative aneurysm excluded; blood pressure in the left arm was significantly diminished immediately after the stent-graft was released, but adequate collateral retrograde perfusion via the left vertebral artery was apparent in all patients. No neurological deficit and no symptoms of left arm ischemia were observed in a follow-up that ranged from 14 to 20 months. Conclusions: Our limited experience shows that occlusion of the left subclavian artery with a stent-graft is well tolerated. If ischemic symptoms occur, a transposition procedure can be performed on an elective basis.

Intentional Left Subclavian Artery Occlusion by Thoracic Aortic Stent-Grafts Without Surgical Transposition

2001 ◽  
Vol 8 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Klaus A. Hausegger ◽  
Peter Oberwalder ◽  
Kurt Tiesenhausen ◽  
Josef Tauss ◽  
Olaf Stanger ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Artery Occlusion ◽  
Stent Grafts ◽  
Subclavian Artery Occlusion

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

2009 ◽  
Vol 19 (10) ◽  
pp. 2407-2415 ◽  
Author(s):  
Fabrizio Fanelli ◽  
Michael D. Dake ◽  
Filippo Maria Salvatori ◽  
Armando Pucci ◽  
Giuseppe Mazzesi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Management Strategies ◽  
Artery Occlusion ◽  
Safe Procedure ◽  
Subclavian Artery Occlusion ◽  
Stent Graft Repair ◽  
Thoracic Stent Graft

Aortic Debranching for Descending Thoracic Aortic Aneurysm Repair by Stent Grafts

2007 ◽  
Vol 73 (1) ◽  
pp. 32-36
Author(s):  
Chandra Cherukupalli ◽  
Amit J. Dwivedi ◽  
Rajeev Dayal ◽  
Khambapatty V. Krishnasastry
Keyword(s):  
Aortic Aneurysm ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Thoracic Aortic Aneurysm ◽  
Left Subclavian Artery ◽  
Artery Bypass ◽  
Celiac Artery ◽  
Stent Grafts ◽  
Descending Thoracic Aortic Aneurysm ◽  
Aneurysm Repair

Endovascular repair of a descending thoracic aortic aneurysm may result in covering the ostia of the left carotid or left subclavian artery for proper proximal landing zones, and the celiac artery or superior mesenteric artery ostia in the abdomen for distal landing zones. To prevent possible complications of occluding the ostia of these vessels, the authors performed an innominate to left common carotid and left subclavian artery bypass as the first procedure in one patient. In the second patient they performed an aortoceliac and aortomesenteric bypass before stent graft placement. The stent graft repair of the descending thoracic aortic aneurysm was performed subsequently in both patients. This aortic debranching provides subsequent proper placement of thoracic stent grafts.

scholarly journals Acute Basilar Artery Occlusion in a Patient With Left Subclavian Artery Occlusion Due to First Rib Anomaly

2008 ◽  
Vol 48 (8) ◽  
pp. 355-358 ◽  
Author(s):  
Rei YAMAGUCHI ◽  
Hideaki KOHGA ◽  
Minori KUROSAKI ◽  
Masaru TAMURA ◽  
Soukichi TANAKA ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Basilar Artery ◽  
Left Subclavian Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
First Rib ◽  
Subclavian Artery Occlusion

Outcomes of Total Endovascular Aortic Arch Repair with Surgeon-Modified Fenestrated Stent-Grafts on Zone 0 Landing for Aortic Arch Pathologies

2021 ◽  
pp. 152660282110364
Author(s):  
Xiaoye Li ◽  
Lei Zhang ◽  
Chao Song ◽  
Hao Zhang ◽  
Shibo Xia ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Artery Occlusion ◽  
Technical Success ◽  
Stent Grafts ◽  
Landing Zone ◽  
Subclavian Artery Occlusion ◽  
Fenestrated Stent Graft ◽  
Aortic Arch Repair

Objectives This study evaluated the feasibility and safety of total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft on zone 0 landing for aortic arch pathologies. Methods Between June 2016 and October 2019, 37 consecutive patients underwent total endovascular arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing. Outcomes included technical success, perioperative and follow-up morbidity and mortality, and branch artery patency. Results During the study period, 37 patients were treated with total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft. Twenty-one (56.8%) patients were diagnosed with aortic dissections, 15 (40.5%) patients with aneurysms, and 1 (2.7%) patient required reintervention due to endoleak and sac expansion from previous thoracic endovascular aortic repair for thoracoabdominal aneurysm. The proximal landing zone for all patients were in zone 0, and all branch arteries of aortic arch were reconstructed. Technical success was achieved in 34 cases (91.9%). Three (8.1%) patients had fenestrations misaligned with target arteries, and the chimney technique was applied as a complementary measure. Thirty-day mortality rate was 5.4% (n=2). Thirty-day stroke rate was 5.4% (n=2). Thirty-day reintervention rate was 2.7% (n=1). At a median follow-up of 20 months (range, 3–49 months), 5 (13.5%) patients died, including 2 aortic-related deaths, 1 nonaortic-related death, and 2 deaths of unknown reason. One (2.7%) patient had stroke. Four patients (10.8%) had reintervention during the follow-up, including 2 cases of left subclavian artery occlusion and 2 cases of type II endoleak. The estimated survival (±SE) at 2 years was 72.4%±9.7% (95% CI 53.4%–91.4%). The estimated freedom from reintervention (±SE) at 2 years was 87.4%±5.9% (95% CI 75.84%–98.96%). Conclusions Total endovascular aortic arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing is an alternate option for the treatment of aortic arch pathologies in experienced centers.

Chetham-platinum-covered stent, aortic coarctation, and left subclavian artery: sometimes is there one too many?

2019 ◽  
Vol 29 (10) ◽  
pp. 1302-1304
Author(s):  
Vincenzo Tufaro ◽  
Gianfranco Butera
Keyword(s):  
Subclavian Artery ◽  
Balloon Angioplasty ◽  
Aortic Coarctation ◽  
Left Subclavian Artery ◽  
Percutaneous Treatment ◽  
Artery Occlusion ◽  
Covered Stent ◽  
Stent Deployment ◽  
New Approach ◽  
Subclavian Artery Occlusion

AbstractA new approach was used in the percutaneous treatment of two patients with severe recoarctation involving the origin of the left subclavian artery. A tiny handmade fenestration was created in a NuMED-covered Cheatham-platinum stent before its implantation to avoid left subclavian artery occlusion. The stent placement was performed using a two-guidewire technique in which the different stiffness helped a proper positioning of the stent. After the stent deployment, the fenestration was enlarged performing a balloon angioplasty to improve flow in left subclavian artery.

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