Hybrid Repair of Ruptured Type B Aortic Dissection Extending into an Aberrant Right Subclavian Artery in a Patient With Turner's Syndrome

Hamidian-Jahromi, Alireza; Carroll, Jonathan; Doucet, Linda; Zhang, Wayne W.

doi:10.1016/j.avsg.2013.04.007

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…The final review included eight relevant case series 4 5 6 7 8 9 10 11 and 24 single case reports 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 comprising a total of 85 patients ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

How to Treat Type B Aortic Dissections in the Presence of an Aberrant Right Subclavian Artery: A Systematic Review

et al. 2023

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An aberrant right subclavian artery (ARSA) is the most common congenital variant of the aortic arch. Usually, this variation is largely asymptomatic, but sometimes it may be involved in aortic dissection (AD). Surgical management of this condition is challenging. The therapeutic options have been enriched in recent decades by establishing individualized endovascular or hybrid procedures. Whether these less invasive approaches bear advantages, and how they have changed the treatment of this rare pathology, is still unclear. Therefore, we conducted a systematic review. We performed a review of literature from the past 20 years (from January 2000 until February 2021) complying with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. All reported patients treated for Type B AD in the presence of an ARSA were identified and classified into three groups according to the received therapy (open, hybrid, and total endovascular). Patient characteristics, as well as in-hospital mortality, and major and minor complications were determined and statistically analyzed. We identified 32 relevant publications comprising 85 patients. Open arch repair has been offered to younger patients, but significantly less often in symptomatic patients needing urgent repair. Therefore, the maximum aortic diameter was also significantly larger in the open repair group compared with that in the hybrid or total endovascular repair group. Regarding the endpoints, we did not find significant differences. The literature review revealed that open surgical therapies are preferred in patients presenting with chronic dissections and larger aortic diameters, most likely because they are unsuitable for endovascular aortic repair. Hybrid and total endovascular approaches are more often applied in emergency situations, where aortic diameters remain smaller. All therapies demonstrated good, early, and midterm outcomes. But, these therapies carry potential risks in the long term. Therefore, long-term follow-up data are urgently needed to validate that these therapies are sustainable.

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Section: Resultsmentioning

confidence: 99%

How to Treat Type B Aortic Dissections in the Presence of an Aberrant Right Subclavian Artery: A Systematic Review

et al. 2023

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“…Coexistence of type B dissection and an ARSA is extremely rare. Due to a limited number of reported case studies [5][6][7][8][9][10], there is no standard surgical procedure for the treatment of this anomaly. An ARSA increases the surgical difficulty and adds risks to the surgical treatment of type B dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior cerebral circulation is dependent upon the left and right subclavian artery, so the endograft should be deployed precisely to avoid exclusion of the origin of the LSCA. Otherwise, pre-emptive transposition or bypass of the subclavian artery should be carried out to prevent cerebral complications: the hybrid method [5][6][7]10]. In patients with inadequate landing zones, debranching of the supra-aortic arch vessels is done to create an adequate proximal landing zone for TEVAR.…”

Section: Discussionmentioning

confidence: 99%

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Repair of complicated type B dissection with an aberrant right subclavian artery

Zhu

Liu

et al. 2016

Interact CardioVasc Thorac Surg

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In patients not undergoing descending aortic replacement, the stented elephant trunk method is our preferred procedure for this anomaly via a median sternotomy. Repair of type B dissection and revascularization of the ARSA were achieved in a single stage using this technique. Satisfactory surgical results and follow-up outcomes were obtained. There was no right upper-limb ischaemia or neurological deficit in patients without ARSA revascularization, but revascularization of the ARSA is recommended for this vessel anomaly.

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Endovascular Repair with Periscope Technique for Aortic Dissection with an Aberrant Right Subclavian Artery

Ding

Jiang

2017

Annals of Vascular Surgery

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Hybrid Repair of Ruptured Type B Aortic Dissection Extending into an Aberrant Right Subclavian Artery in a Patient With Turner's Syndrome

Cited by 6 publications

References 11 publications

How to Treat Type B Aortic Dissections in the Presence of an Aberrant Right Subclavian Artery: A Systematic Review

How to Treat Type B Aortic Dissections in the Presence of an Aberrant Right Subclavian Artery: A Systematic Review

Repair of complicated type B dissection with an aberrant right subclavian artery

Endovascular Repair with Periscope Technique for Aortic Dissection with an Aberrant Right Subclavian Artery

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