The safety and efficacy of left subclavian artery reconstruction through in situ needle fenestration in thoracic endovascular aortic repair

Abstract

Abstract In recent years, thoracic endovascular aortic repair (TEVAR) with left subclavian artery (LSA) preservation via in situ needle fenestration has been performed at the author's hospital for the treatment of thoracic aortic diseases and has achieved good clinical results. This study analyzed the safety and effectiveness of this method by summarizing relevant data. The study retrospectively analyzed the relevant clinical data of the patients, including demographic information, clinical manifestations, perioperative outcomes and follow-up results. The number of fenestrations and the specifications of the fenestration stent were determined according to preoperative computed tomographic arteriography (CTA) imaging data. The LSA was reconstructed by using in situ needle fenestration technique, and CTA was performed at the initial 3-month visit and then annually thereafter. All patients were successfully operated on, and the success rate of in situ fenestration of the left subclavian artery (LSA) was 100%. The mean follow-up duration was 31 months (range: 6-78 months). Follow-up CTA showed no progression of aortic lesions in any patient and no fenestration branch vessel occlusion. In situ needle fenestration technology for LSA preservation in TEVAR is feasible and effective for the treatment of thoracic aortic diseases. The follow-up results are satisfactory, and the technique has a high success rate, high subclavian artery stent patency rate and a low complication rate.