Background: Thoracic Endovascular Aortic Repair has been widely performed to treat various thoracic aortic pathologies. However, stent-graft placement in the thoracic aorta may result in left subclavian artery coverage, potentially leading to ischemic complications. The role of the left subclavian artery revascularization procedure to prevent ischemic complications remains controversial. Therefore, we conducted a systematic review and meta-analysis to identify ischemic outcomes in patients who underwent thoracic Endovascular Aortic Repair with or without left subclavian artery revascularization.
Methods: A systematic search through electronic databases, including PubMed, Ovid Medline, and Cochrane, was conducted to identify relevant studies. The outcome parameters were left arm ischemia, stroke, and spinal cord ischemia. Risk ratio (RR) and Confidence Interval (CI) of 95% were measured and reported.
Results: A total of 11,386 patients were identified from 22 studies. Patients who underwent left subclavian artery revascularization had lower risk of left arm ischemia (RR 0.25, 95% CI 0.09-0.68; P = 0.0006; I = 71%), lower risk of stroke (RR 0.52, 95% CI 0.30-0.88; P = 0.02; I = 70%), and lower risk of spinal cord ischemia (odds ratio OR 0.72, 95% CI 0.55-0.95; P = 0.02; I = 0%) between the 2 groups.
Conclusions: Revascularization procedure in patients with left subclavian artery coverage during thoracic Endovascular Aortic Repair is associated with a lower risk of left arm ischemia, stroke, and spinal cord ischemia. Left subclavian artery revascularization should be performed in anatomically high-risk patients. High-quality studies are needed to validate the outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.avsg.2022.04.037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endovascular single-branched stent graft to treat complicated type B aortic dissection involving aortic arch anomalies.
Eur J Med Res
December 2024
Department of Peripheral Vascular Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, Shaanxi, China.
Background: The optimal treatment of complicated type B aortic dissection (cTBAD) involving arch anomalies remain unclear.
Methods: We consecutively enrolled patients with cTBAD involving arch anomalies who underwent endovascular repair using a single-branched stent graft (SBSG) at our medical center between January 2020 and January 2023. The demographics, clinical manifestation, operation detail, and follow-up outcomes of these patients were retrospectively collected and analyzed.
Preventing Spinal Cord Injury in Single-Staged Juxtarenal and Thoracoabdominal Endovascular Aortic Aneurysm Repair: An Evaluation of Cerebrospinal Fluid Catheter Drainage.
J Endovasc Ther
December 2024
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Austria.
Objective: This study offers a retrospective assessment of a single-center experience using cerebrospinal fluid catheters to reduce the risk of perioperative spinal cord injury in patients undergoing single-staged complex endovascular juxtarenal or thoracoabdominal aortic aneurysm repair.
Results: A total of 97 patients were included. On average, 70.
Current management of uncomplicated type B aortic dissection.
Ann Vasc Surg
December 2024
MemorialCare Heart and Vascular Institute, 2801 Atlantic Ave., Long Beach, CA 90806.
Aortic dissection is the most common thoracic aortic emergency and is associated with significant morbidity and mortality. Initial complications are dependent on reduction of sheer stress against the aortic wall to protect against rupture and minimize progression of the aortic wall injury. In patients with dissection starting at or distal to the left subclavian artery (Stanford type B), initial management includes strict blood pressure and heart rate control with monitoring for any complications such as malperfusion, rupture or hemodynamic instability.
View Article and Find Full Text PDFAnalysis of associated malformations by computed tomography in adults with polysplenia syndrome: A pilot study.
PLoS One
December 2024
Department of Medical Imaging, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou, Jiangsu, China.
Objective: To analytically depict the associated malformations of polysplenia syndrome (PS) in adults via computed tomography (CT).
Materials And Methods: The incidence of malformations associated with PS in twelve adult patients was retrospectively analyzed via CT imaging.
Results: The number of splenic nodules ranged from three to twelve; the splenic nodules were located in the left upper quadrant in nine patients and in the right upper quadrant in three patients.
A clinical perspective on surgical and diagnostic strategies for neonatal partial shone complex: Insights from a case report.
Int J Surg Case Rep
December 2024
The Internist Cardiologist, Department of Cardiology, Al Watani Hospital, Hama, Syria.
Introduction And Clinical Importance: Shone complex (SC) is a rare multilevel congenital heart disease (CHD) characterized by four left-sided heart obstructive lesions: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta (CoA), accounting for 0.6-0.7 % of CHD cases.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!