Thorac Cardiovasc Surg 2009; 57(4): 240-242
DOI: 10.1055/s-2008-1039220
Short Communications

© Georg Thieme Verlag KG Stuttgart · New York

Subclavian Embolization Associated to Carotid-Subclavian Bypass and Stent-Graft Repair of Acute Type-B Dissection

L. Botta1 , C. La Palombara2 , M. Rosati2 , R. Di Bartolomeo1 , R. Fattori2
  • 1Cardiac Surgery Unit, Cardiothoracovascular Department, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • 2Cardiovascular Radiology Unit, Cardiothoracovascular Department, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
Further Information

Publication History

received September 8, 2008

Publication Date:
20 May 2009 (online)

Abstract

Intentional closure of the left subclavian artery (LSA) during an endovascular procedure can be complicated by retrograde filling of the excluded aorta, increasing the risk of aneurysm expansion and sudden rupture. Retrograde coil embolization of the LSA, as alternative to open subclavian ligature, is a safe and effective method of rapid false lumen sealing in patients requiring coverage of the LSA and carotid-subclavian bypass, even in the setting of acute aortic syndromes.

References

  • 1 Szeto W Y, McGarvey M, Pochettino A. et al . Results of a new surgical paradigm: endovascular repair for acute complicated type B aortic dissection.  Ann Thorac Surg. 2008;  86 87-93
  • 2 Brett Reece T, Gazoni L M, Cherry K J. et al . Reevaluating the need for left subclavian artery revascularization with thoracic endovascular aortic repair.  Ann Thorac Surg. 2007;  84 1201-1205
  • 3 Sheehan M K, Ouriel K, Greenberg R. et al . Are type II endoleaks after endovascular aneurysm repair endograft dependent?.  J Vasc Surg. 2006;  43 657-661
  • 4 Svensson L G, Kouchoukos N T, Miller D C. et al . Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts.  Ann Thor Surg. 2008;  85 (Suppl. 1) S1-S41
  • 5 Tsai T T, Fattori R, Trimarchi S. et al . Long-term survival in patients presenting with type B acute aortic dissection. Insights from the International Registry of Acute Aortic Dissection.  Circulation. 2006;  114 2226-2231
  • 6 Rehders T C, Petzsch M, Ince H. et al . Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta: risk and relevance.  J Endovasc Ther. 2004;  11 659-666
  • 7 Noor N, Sadat U, Hayes P D. et al . Management of the left subclavian artery during endovascular repair of the thoracic aorta.  J Endovasc Ther. 2008;  15 168-176
  • 8 Weigang E, Luehe M, Harloff A. et al . Incidence of neurological complications following overstenting of the left subclavian artery.  Eur J Cardiothorac Surg. 2007;  31 628-636
  • 9 Cina C S, Safar H A, Lagana’ A, Arena G, Clase C M. Subclavian carotid transposition and bypass grafting: consecutive cohort study and systematic review.  J Vasc Surg. 2002;  35 422-429
  • 10 Demers P, Miller C D, Mitchell R S. et al . Midterm results of endovascular repair of descending thoracic aortic aneurysms with first generation stentgrafts.  J Thorac Cardiovasc Surg. 2004;  127 664-673
  • 11 Tuite D J, Kessel D O, Nicholson A A. et al . Initial clinical experience using the Amplatzer vascular plug.  Cardiovasc Intervent Radiol. 2007;  30 650-654

Prof. MD Rossella Fattori

Cardiovascular Radiology Unit, Cardiothoracovascular Department
S. Orsola-Malpighi Hospital
University of Bologna

Via Massarenti 9

40133 Bologna

Italy

Phone: + 39 (0) 5 16 36 47 47

Fax: + 39 (0) 51 34 59 90

Email: rossella.fattori@unibo.it

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