Effect of left subclavian artery coverage on ischemic stroke during thoracic endovascular aortic repair / 中华普通外科杂志

ABSTRACT

Objective To investigate the effect of left subclavian artery (LSA) coverage on ischemic stroke complications in thoracic aortic cavity repair (TEVAR).Methods The clinical data of 69 patients undergoing TEVAR with LSA coverage from Jun 2013 to Jan 2018 were retrospectively analyzed.Results There were 56 males and 13 females,average age of S1.1(32-76).Perioperative mortality was 4.3％ (3/69) and stroke related mortality was 1.4％ (1/69).There were 2 cases (2/66,3.0％) of symptomatic stroke in perioperative period and 5 cases (5/66,7.6％) of cryptogenic stroke,inclucling 2 cases of anterior circulation ischemia (2/66,3.0％),3 cases of posterior circulation ischemia (3/66,4.5％),and 2 cases of multiple ischemia (2/66,3.0％).48 cases (72.7％) of vertebral blood steal were grade Ⅰ,15 cases (22.7％) were Ⅱ and 3 cases (4.5％) were Ⅲ.No new stroke related deaths happened in 6 months,there were 3 cases of symptomatic stroke (3/66,4.5％) and 13 cases of cryptogenic stroke (13/66,19.7％).There were 3 cases of anterior circulation ischemia (3/66,4.4％),8 cases of posterior circulation ischemia (8/66,12.1％) and 5 cases of multiple ischemia (5/66,7.6％)respectively.Conclusion The compensation mechanism of LSA itself reduces the serious ischemic stroke risk caused by LSA coverage.