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Thorac Cardiovasc Surg
DOI: 10.1055/a-2607-6327
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A Novel Sheath Aligning Method of Left Subclavian Artery Revascularization in TEVAR

Yu Zhang   *
1   Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
,
Heng Wang   *
1   Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
,
Jidong Liu
1   Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
,
Song Xue
1   Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
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Abstract

Concomitant left subclavian artery (LSA) fenestration is recommended in thoracic endovascular aortic repair (TEVAR) for revascularization when the LSA is covered. However, the sheath alignment lacks an accurate and efficient positioning method due to the angulation of LSA anatomy. We developed a novel method for sheath aligning characterized by the guiding catheter's front junction (J.) with the graft stent and descending (D.) aorta proceeding. It forms a curved traction system that drags the puncture needle to the center of LSA orifice. A 93.8% endoleak-free rate was observed during the 9.0 (4.0–17.5) months follow-up in 137 patients. No reintervention or mortality was observed. Our sheath aligning method can be safely performed in LSA fenestration, which simplifies the surgical procedure and may help to avoid iatrogenic complications.

Keywords

aorta/aortic - stents - vascular science (biochemistry pharmacology pathology etc.) - endovascular procedures/stents except PCI

* These authors contributed equally to this work.


Authors' Contribution

Y.Z. collected images and clinical data before 2022, wrote the original manuscript; H.W. collected clinical data in 2022 and 2023, made key revisions to the manuscript, performed data analysis. J.L. provided key innovations for the technical solution. S.X. performed surgical procedures and designed the study.




Publication History

Received: 22 September 2024

Accepted: 12 May 2025

Article published online:
03 June 2025

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