Analysis on Thoracic Endovascular Aortic Repair and Endoleak of“Chimney”Technique for Treating the Patients With Thoracic Aortic Lesions / 中国循环杂志

ABSTRACT

Objective: To investigate thoracic endovascular aortic repair (TEVAR) and “Chimney” technique for treating the involved left common carotid artery (LCCA) or left subclavian artery (LSA) in Standford B patients with aortic lesion and in-sufficient proximal anchoring area. Meanwhile, to explore the relationship between endoleaking condition and the location of lesion with the prognosis. Methods: A total of 32 relevant patients treated by TEVAR + “Chimney” technique in our hospital from 2011-09 to 2015-07 were retrospectively analyzed. Immediate post-operative image development of LCCA or LSA was observed; cerebral complications, severe upper limb ischemic symptoms and endoleaking conditions were recorded. The patients were followed-up for (3-46) months. Results: Thoracic aortic stent-graft placement was successfully carried out in all 32 patients. Immediate post-operative image development of LCCAor LSAwas favorable, no cerebral complications and no severe upper limb ischemic symptoms were observed. There were 7 patients suffered from endoleak at aortic arch including 6 with the lesion located at the greater curvature side and 1 at the small curvature side. During follow-up period, aortic stent-graft remained in a stable condition and the blood flow in “Chimney” stent was unobstructed. Endoleking condition was gradually reduced and disappeared in 5 patients, it was persisted in 2 patients. Conclusion: “Chimney” technique may prolong anchoring area and keep LCCA or LSA unobstructed, therefore expand the indication of TEVAR in a mini-invasive, safe and effective way. When aortic lesion located at the greater curvature side, the endoleaking probability could be increased.