The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion Of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70 +/- 24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 9 months, for Visual impairment. Type II endoleaks from excluded LSA Occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required.

Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure? / Fabrizio, Fanelli; Michael D., Dake; Filippo Maria, Salvatori; Armando, Pucci; Mazzesi, Giuseppe; Lucatelli, Pierleone; Rossi, Plinio; Passariello, Roberto. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 19:10(2009), pp. 2407-2415. [10.1007/s00330-009-1433-3]

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

MAZZESI, Giuseppe;LUCATELLI, PIERLEONE;ROSSI, Plinio;PASSARIELLO, Roberto
2009

Abstract

The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion Of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70 +/- 24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 9 months, for Visual impairment. Type II endoleaks from excluded LSA Occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required.
2009
aorta; aortic dissection; stent-graft; thoracic aneurysm
01 Pubblicazione su rivista::01a Articolo in rivista
Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure? / Fabrizio, Fanelli; Michael D., Dake; Filippo Maria, Salvatori; Armando, Pucci; Mazzesi, Giuseppe; Lucatelli, Pierleone; Rossi, Plinio; Passariello, Roberto. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 19:10(2009), pp. 2407-2415. [10.1007/s00330-009-1433-3]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/27908
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