Management of an Isolated Left Vertebral Artery on the Arch During Zone 2 Landing Thoracic Endovascular Aortic Repair: A Multicentre Retrospective Study

Zhang, Heng; Feng, Jiaxuan; Guo, Mingzhou; Liu, Junjun; Xu, Dianguo; Lu, Yao; Zhu, Hongqiao; Liu, Mingyuan; Feng, Rui

doi:10.1016/j.ejvs.2022.11.007

Cited by 7 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An endovascular approach was worth trying to provide a less invasive and more expeditious method which can be completed in one stage. Table 4 ( 9 , 18 , 19 , 23 – 25 ) has summarized the results of various techniques for ILVA revascularization from currently published case series (number of patients >1) to date.…”

Section: Discussionmentioning

confidence: 99%

Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair

Shen

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectiveTo present our experience of preserving the isolated left vertebral artery (ILVA) with physician-modified fenestration (PM-F) or in situ fenestration (ISF) during thoracic endovascular aortic repair (TEVAR) for aortic pathologies involving aortic arch.MethodsThis is a single-center, retrospective, observational cohort study. Between June 2016 and December 2021, 9 patients (8 men; median age 60.0 years old) underwent TEVAR with ILVA reconstruction (PM-F, n = 6; ISF, n = 3) were identified and analyzed.ResultsThe technical success rate was 100%. No early (<30 days) death occurred. No aortic rupture, major stroke or spinal cord injury was observed. The median follow up was 38.0 (rang: 1.0–66.0) months. One death occurred at 56 months, while the reason cannot be identified. No aortic rupture, major stroke or spinal cord injury was observed during follow up. No patient required reintervention. Out of the 22 successfully revascularized target vessels, 2 ILVAs were found occluded in 2 patients at 6 months and 7 months, respectively. However, these two patients were asymptomatic.ConclusionsOur initial experience reveals that PM-F or ISF for ILVA preservation was feasible, safe, and effective during TEVAR for complex thoracic aortic pathologies. However, the patency of preserved ILVA should be improved.

show abstract

Section: Discussionmentioning

confidence: 99%

Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair

Shen

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…The outcomes of hybrid thoracic endovascular aortic repair (TEVAR) have been reported to be worse when performed in more proximal landing zones [ 1 , 2 ]. There are many reports of zone 0- and zone 2-landing hybrid TEVAR for aortic arch diseases, but few reports of zone 1-landing hybrid TEVAR [ 2 , 3 , 4 , 5 , 6 , 7 ]. This is because an extra-anatomical bypass (right axillary artery [AxA]–left common carotid artery [LCCA]–left AxA bypass) and intracranial blood flow from the brachiocephalic artery (BCA) are required for zone 1-landing hybrid TEVAR.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Effectiveness of Zone 1-Landing Hybrid TEVAR by Comparing Its Outcomes with Those of Zone 2-Landing Hybrid TEVAR

Kudo

Kuratani

Sawa

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Hybrid thoracic endovascular aortic repair (TEVAR) without median sternotomy is increasingly being performed in high-risk patients with aortic arch disease. The outcomes of hybrid TEVAR were reported to be worse with a more proximal landing zone. This study aims to clarify the effectiveness of zone 1-landing hybrid TEVAR by comparing the outcomes of zone 2-landing hybrid TEVAR. Methods: From April 2008 to October 2020, 213 patients (zone 1: zone 1-landing hybrid TEVAR, n = 82, 38.5%; zone 2: zone 2-landing hybrid TEVAR, n = 131, 61.5%) were enrolled (median age, 72 years; interquartile range [IQR], 65–78 years), with a median follow-up period of 6.0 years (IQR, 2.8–9.7 years). Results: The mean logistic EuroSCORE was 20.9 ± 14.8%: the logistic EuroSCORE of the zone 1 group (23.3 ± 16.1) was significantly higher than that of the zone 2 group (19.3 ± 12.4%, p = 0.045). The operative time and hospital stay of the zone 1 group were significantly longer than those of the zone 2 group. On the other hand, the in-hospital and late outcomes did not differ significantly between the two groups. There were no significant differences in cumulative survival (66.8% vs. 78.0% at 10 years, Log-rank p = 0.074), aorta-related death-free rates (97.6% vs. 99.2% at 10 years, Log-rank p = 0.312), and aortic event-free rates (81.4% vs. 87.9% at 10 years, Log-rank p = 0.257). Conclusions: Zone 1- and 2-landing hybrid TEVAR outcomes were satisfactory. Despite the high procedural difficulty and surgical risk, the outcomes of zone 1-landing hybrid TEVAR were equal to those of zone 2-landing hybrid TEVAR. If the surgical risk is high, zone 1-landing hybrid TEVAR should not be avoided.

show abstract

Transposition of an anomalous left vertebral artery followed by endovascular treatment of descending thoracic aortic aneurysm using a branched endoprosthesis

do Lago Franco,

Hatoum,

Müller

et al. 2024

Annals of Vascular Surgery - Brief Reports and Innovations

View full text Add to dashboard Cite

Management of an Isolated Left Vertebral Artery on the Arch During Zone 2 Landing Thoracic Endovascular Aortic Repair: A Multicentre Retrospective Study

Cited by 7 publications

References 20 publications

Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair

Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair

Assessment of the Effectiveness of Zone 1-Landing Hybrid TEVAR by Comparing Its Outcomes with Those of Zone 2-Landing Hybrid TEVAR

Transposition of an anomalous left vertebral artery followed by endovascular treatment of descending thoracic aortic aneurysm using a branched endoprosthesis

Contact Info

Product

Resources

About