2 YEAR PATENCY OF THE LEFT VERTEBRAL ARTERY AFTER CAROTID-SUBCLAVIAN BYPASS OR TRANSPOSITION BEFORE THORACIC ENDOVASCULAR AORTIC REPAIR IN ZONE II.

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2025-07-21 DOI:10.1016/j.avsg.2025.07.031

Aude Gatinot, Simon Rinckenbach, Thomas Foret, Tom Le Corvec, Guillaume Guimbretière, Blandine Maurel

{"title":"2 YEAR PATENCY OF THE LEFT VERTEBRAL ARTERY AFTER CAROTID-SUBCLAVIAN BYPASS OR TRANSPOSITION BEFORE THORACIC ENDOVASCULAR AORTIC REPAIR IN ZONE II.","authors":"Aude Gatinot, Simon Rinckenbach, Thomas Foret, Tom Le Corvec, Guillaume Guimbretière, Blandine Maurel","doi":"10.1016/j.avsg.2025.07.031","DOIUrl":null,"url":null,"abstract":"Background: Carotid subclavian artery bypass (CSB) and subclavian transposition (SCT) are the two surgical options for revascularization of the left subclavian artery (LSA) prior to coverage during thoracic endovascular aneurysm repair (TEVAR) in zone 2. This helps to prevent spinal cord injury by maintaining blood flow to the spine via the vertebral artery. The aim was to compare CSB with SCT prior to TEVAR regarding vertebral patency and surgical outcomes.Methods: Bicentric retrospective comparative study of consecutive patients who underwent CSB or SCT for thoracic aortic disease (dissection, aneurysm, lusoria) from 2017 to 2022.Results: 86 patients were included: 41 bypasses and 49 transpositions. Median follow-up was 27 and 24.8 months, respectively. Indications for TEVAR were aneurysm (42.2%) and aortic dissection (57.8%). Complication rate was 24.4% for CSB vs. 8.2% for SCT, including stroke (2.4 vs. 2%), spinal cord injury (4.9 vs. 2%). At 2 years: 6 (14.6%) vertebral arteries and 3 (7.3%) grafts occluded in the CSB group; and 2 (4%) vertebral arteries occluded without LSA event among the SCT.Conclusion: In our experience, CSB prior to LSA coverage by TEVAR shows a higher rate of postoperative complications and a non-significant higher incidence of vertebral and LSA occlusion as compared to SCT.","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.avsg.2025.07.031","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Carotid subclavian artery bypass (CSB) and subclavian transposition (SCT) are the two surgical options for revascularization of the left subclavian artery (LSA) prior to coverage during thoracic endovascular aneurysm repair (TEVAR) in zone 2. This helps to prevent spinal cord injury by maintaining blood flow to the spine via the vertebral artery. The aim was to compare CSB with SCT prior to TEVAR regarding vertebral patency and surgical outcomes.

Methods: Bicentric retrospective comparative study of consecutive patients who underwent CSB or SCT for thoracic aortic disease (dissection, aneurysm, lusoria) from 2017 to 2022.

Results: 86 patients were included: 41 bypasses and 49 transpositions. Median follow-up was 27 and 24.8 months, respectively. Indications for TEVAR were aneurysm (42.2%) and aortic dissection (57.8%). Complication rate was 24.4% for CSB vs. 8.2% for SCT, including stroke (2.4 vs. 2%), spinal cord injury (4.9 vs. 2%). At 2 years: 6 (14.6%) vertebral arteries and 3 (7.3%) grafts occluded in the CSB group; and 2 (4%) vertebral arteries occluded without LSA event among the SCT.

Conclusion: In our experience, CSB prior to LSA coverage by TEVAR shows a higher rate of postoperative complications and a non-significant higher incidence of vertebral and LSA occlusion as compared to SCT.

查看原文本刊更多论文

颈动脉-锁骨下搭桥或转位后左椎动脉2年通畅，胸椎ii区血管内主动脉修复。

背景：颈动脉锁骨下动脉搭桥术（CSB）和锁骨下转位术（SCT）是胸2区血管内动脉瘤修复术（TEVAR）覆盖前左锁骨下动脉（LSA）血运重建的两种手术选择。这有助于通过椎动脉维持血液流向脊柱，从而防止脊髓损伤。目的是比较在TEVAR前CSB和SCT对椎体通畅和手术结果的影响。方法：对2017年至2022年连续接受CSB或SCT治疗胸主动脉疾病（夹层、动脉瘤、溃疡）的患者进行双中心回顾性比较研究。结果：86例患者：41例旁路，49例转位。中位随访时间分别为27个月和24.8个月。TEVAR的适应症为动脉瘤（42.2%）和主动脉夹层（57.8%）。CSB的并发症发生率为24.4%，SCT为8.2%，包括卒中（2.4 vs. 2%），脊髓损伤（4.9 vs. 2%）。2年时，CSB组有6条（14.6%）椎动脉闭塞，3条（7.3%）移植物闭塞；SCT中2例（4%）椎动脉闭塞，无LSA事件。结论：根据我们的经验，与SCT相比，在TEVAR覆盖LSA之前的CSB显示出更高的术后并发症发生率，并且椎体和LSA闭塞的发生率不明显更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence