Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance
Purpose: To examine the clinical consequences and/or potential need for postinterventional transposition after stent-graft occlusion of the left subclavian artery (LSA). Methods: The records of 171 consecutive patients (128 men; mean age 60.2±13.2 years, range 20–83) undergoing elective stent-graft...
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| Veröffentlicht in: | Journal of endovascular therapy 2004-12, Vol.11 (6), p.659-666 |
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| container_title | Journal of endovascular therapy |
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| creator | Rehders, Tim C. Petzsch, Michael Ince, Hüseyin Kische, Stephan Körber, Thomas Koschyk, Dietmar H. Chatterjee, Tushar Weber, Frank Nienaber, Christoph A. |
| description | Purpose:
To examine the clinical consequences and/or potential need for postinterventional transposition after stent-graft occlusion of the left subclavian artery (LSA).
Methods:
The records of 171 consecutive patients (128 men; mean age 60.2±13.2 years, range 20–83) undergoing elective stent-graft repair in the thoracic aorta were reviewed to identify intentional endograft coverage of the ostial LSA, as documented by transesophageal echocardiography and/or aortography. Patients were treated for subacute type B dissection, true aneurysm, pseudoaneurysm, or previously operated type A dissection with persistent false lumen flow in the descending aorta. Among the 171 cases, 22 (12.9%) patients were identified with stent-graft occlusion of the LSA.
Results:
A systolic blood pressure differential existed between the right (138.4±14.0 mmHg) and the left (101.8±21.0 mmHg; p |
| doi_str_mv | 10.1583/04-1311R.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67218449</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_04-1311R.1</sage_id><sourcerecordid>67218449</sourcerecordid><originalsourceid>FETCH-LOGICAL-c410t-17752e1ee2175212643ec106f4fd3f0b5c1e549213ab03f18ea37c0dd5da8b643</originalsourceid><addsrcrecordid>eNptkU9LAzEQxYMo_r_4ASR4UBBWM9lku3orRWuhIFQ9h2x2tl3dZmuSFTz43c3agiCe5h1-82Z4j5ATYFcg8_SaiQRSgNkVbJF9kEImICXb7jXPkozxfI8ceP_KGAcOsEv2QGacpULsk6-JDWhD3Vrd0Edjms5HTduKhgXSKVaBPnWFafRHrS0duoDuk5adq-2cPvWbydjpCE2Wq0bboHsnWtuf7edF67SpDR22LuhbOqv9G9W2pDNs8ENbg0dkp9KNx-PNPCQv93fPo4dk-jiejIbTxAhgIYHBQHIERA5RAM9EigZYVomqTCtWSAMoxQ2HVBcsrSBHnQ4MK0tZ6ryI9CE5X_uuXPveoQ9qWXuDTXwZ286rbMAhF-Imgmd_wNe2czEbr2JyAJIxiNDlGjKu9d5hpVauXmr3qYCpvhHFhPppRPXw6caxK5ZY_qKbCiJwsQa8nuPvuX-svgEdSpGX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211115001</pqid></control><display><type>article</type><title>Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><creator>Rehders, Tim C. ; Petzsch, Michael ; Ince, Hüseyin ; Kische, Stephan ; Körber, Thomas ; Koschyk, Dietmar H. ; Chatterjee, Tushar ; Weber, Frank ; Nienaber, Christoph A.</creator><creatorcontrib>Rehders, Tim C. ; Petzsch, Michael ; Ince, Hüseyin ; Kische, Stephan ; Körber, Thomas ; Koschyk, Dietmar H. ; Chatterjee, Tushar ; Weber, Frank ; Nienaber, Christoph A.</creatorcontrib><description>Purpose:
To examine the clinical consequences and/or potential need for postinterventional transposition after stent-graft occlusion of the left subclavian artery (LSA).
Methods:
The records of 171 consecutive patients (128 men; mean age 60.2±13.2 years, range 20–83) undergoing elective stent-graft repair in the thoracic aorta were reviewed to identify intentional endograft coverage of the ostial LSA, as documented by transesophageal echocardiography and/or aortography. Patients were treated for subacute type B dissection, true aneurysm, pseudoaneurysm, or previously operated type A dissection with persistent false lumen flow in the descending aorta. Among the 171 cases, 22 (12.9%) patients were identified with stent-graft occlusion of the LSA.
Results:
A systolic blood pressure differential existed between the right (138.4±14.0 mmHg) and the left (101.8±21.0 mmHg; p<0.05) arms after occlusion of the LSA. No patient showed a malperfusion syndrome during postinterventional hospitalization. During a mean follow-up of 24.0±15.8 months, 15 (68.2%) patients remained completely asymptomatic, with no functional deficit or temperature differential between the arms, while 7 patients reported mild symptoms of a subclavian steal syndrome. However, no patient required any secondary surgical intervention.
Conclusions:
Stent-graft—induced occlusion of the ostial LSA was tolerated by all patients without chronic functional deficit. In the absence of stenotic vertebral and/or carotid arteries and with a documented intact vertebrobasilar system, prophylactic transposition of the LSA is not required prior to intentional stent-graft occlusion of the LSA.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/04-1311R.1</identifier><identifier>PMID: 15620344</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aneurysm, Ruptured - diagnostic imaging ; Aneurysm, Ruptured - surgery ; Angiography ; Aortic Aneurysm, Thoracic - diagnostic imaging ; Aortic Aneurysm, Thoracic - surgery ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - etiology ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - methods ; Cohort Studies ; Female ; Follow-Up Studies ; Hemodynamics - physiology ; Humans ; Intraoperative Complications - diagnostic imaging ; Intraoperative Complications - physiopathology ; Male ; Middle Aged ; Probability ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Stents - adverse effects ; Subclavian Artery - diagnostic imaging ; Subclavian Artery - physiopathology ; Treatment Outcome</subject><ispartof>Journal of endovascular therapy, 2004-12, Vol.11 (6), p.659-666</ispartof><rights>2004 SAGE Publications</rights><rights>Copyright Allen Press, Inc. Dec 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-17752e1ee2175212643ec106f4fd3f0b5c1e549213ab03f18ea37c0dd5da8b643</citedby><cites>FETCH-LOGICAL-c410t-17752e1ee2175212643ec106f4fd3f0b5c1e549213ab03f18ea37c0dd5da8b643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/04-1311R.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/04-1311R.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21799,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15620344$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rehders, Tim C.</creatorcontrib><creatorcontrib>Petzsch, Michael</creatorcontrib><creatorcontrib>Ince, Hüseyin</creatorcontrib><creatorcontrib>Kische, Stephan</creatorcontrib><creatorcontrib>Körber, Thomas</creatorcontrib><creatorcontrib>Koschyk, Dietmar H.</creatorcontrib><creatorcontrib>Chatterjee, Tushar</creatorcontrib><creatorcontrib>Weber, Frank</creatorcontrib><creatorcontrib>Nienaber, Christoph A.</creatorcontrib><title>Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To examine the clinical consequences and/or potential need for postinterventional transposition after stent-graft occlusion of the left subclavian artery (LSA).
Methods:
The records of 171 consecutive patients (128 men; mean age 60.2±13.2 years, range 20–83) undergoing elective stent-graft repair in the thoracic aorta were reviewed to identify intentional endograft coverage of the ostial LSA, as documented by transesophageal echocardiography and/or aortography. Patients were treated for subacute type B dissection, true aneurysm, pseudoaneurysm, or previously operated type A dissection with persistent false lumen flow in the descending aorta. Among the 171 cases, 22 (12.9%) patients were identified with stent-graft occlusion of the LSA.
Results:
A systolic blood pressure differential existed between the right (138.4±14.0 mmHg) and the left (101.8±21.0 mmHg; p<0.05) arms after occlusion of the LSA. No patient showed a malperfusion syndrome during postinterventional hospitalization. During a mean follow-up of 24.0±15.8 months, 15 (68.2%) patients remained completely asymptomatic, with no functional deficit or temperature differential between the arms, while 7 patients reported mild symptoms of a subclavian steal syndrome. However, no patient required any secondary surgical intervention.
Conclusions:
Stent-graft—induced occlusion of the ostial LSA was tolerated by all patients without chronic functional deficit. In the absence of stenotic vertebral and/or carotid arteries and with a documented intact vertebrobasilar system, prophylactic transposition of the LSA is not required prior to intentional stent-graft occlusion of the LSA.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysm, Ruptured - diagnostic imaging</subject><subject>Aneurysm, Ruptured - surgery</subject><subject>Angiography</subject><subject>Aortic Aneurysm, Thoracic - diagnostic imaging</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Arterial Occlusive Diseases - diagnostic imaging</subject><subject>Arterial Occlusive Diseases - etiology</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Intraoperative Complications - diagnostic imaging</subject><subject>Intraoperative Complications - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Probability</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Stents - adverse effects</subject><subject>Subclavian Artery - diagnostic imaging</subject><subject>Subclavian Artery - physiopathology</subject><subject>Treatment Outcome</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptkU9LAzEQxYMo_r_4ASR4UBBWM9lku3orRWuhIFQ9h2x2tl3dZmuSFTz43c3agiCe5h1-82Z4j5ATYFcg8_SaiQRSgNkVbJF9kEImICXb7jXPkozxfI8ceP_KGAcOsEv2QGacpULsk6-JDWhD3Vrd0Edjms5HTduKhgXSKVaBPnWFafRHrS0duoDuk5adq-2cPvWbydjpCE2Wq0bboHsnWtuf7edF67SpDR22LuhbOqv9G9W2pDNs8ENbg0dkp9KNx-PNPCQv93fPo4dk-jiejIbTxAhgIYHBQHIERA5RAM9EigZYVomqTCtWSAMoxQ2HVBcsrSBHnQ4MK0tZ6ryI9CE5X_uuXPveoQ9qWXuDTXwZ286rbMAhF-Imgmd_wNe2czEbr2JyAJIxiNDlGjKu9d5hpVauXmr3qYCpvhHFhPppRPXw6caxK5ZY_qKbCiJwsQa8nuPvuX-svgEdSpGX</recordid><startdate>200412</startdate><enddate>200412</enddate><creator>Rehders, Tim C.</creator><creator>Petzsch, Michael</creator><creator>Ince, Hüseyin</creator><creator>Kische, Stephan</creator><creator>Körber, Thomas</creator><creator>Koschyk, Dietmar H.</creator><creator>Chatterjee, Tushar</creator><creator>Weber, Frank</creator><creator>Nienaber, Christoph A.</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200412</creationdate><title>Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance</title><author>Rehders, Tim C. ; Petzsch, Michael ; Ince, Hüseyin ; Kische, Stephan ; Körber, Thomas ; Koschyk, Dietmar H. ; Chatterjee, Tushar ; Weber, Frank ; Nienaber, Christoph A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-17752e1ee2175212643ec106f4fd3f0b5c1e549213ab03f18ea37c0dd5da8b643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysm, Ruptured - diagnostic imaging</topic><topic>Aneurysm, Ruptured - surgery</topic><topic>Angiography</topic><topic>Aortic Aneurysm, Thoracic - diagnostic imaging</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Arterial Occlusive Diseases - diagnostic imaging</topic><topic>Arterial Occlusive Diseases - etiology</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Intraoperative Complications - diagnostic imaging</topic><topic>Intraoperative Complications - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Probability</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Stents - adverse effects</topic><topic>Subclavian Artery - diagnostic imaging</topic><topic>Subclavian Artery - physiopathology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rehders, Tim C.</creatorcontrib><creatorcontrib>Petzsch, Michael</creatorcontrib><creatorcontrib>Ince, Hüseyin</creatorcontrib><creatorcontrib>Kische, Stephan</creatorcontrib><creatorcontrib>Körber, Thomas</creatorcontrib><creatorcontrib>Koschyk, Dietmar H.</creatorcontrib><creatorcontrib>Chatterjee, Tushar</creatorcontrib><creatorcontrib>Weber, Frank</creatorcontrib><creatorcontrib>Nienaber, Christoph A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rehders, Tim C.</au><au>Petzsch, Michael</au><au>Ince, Hüseyin</au><au>Kische, Stephan</au><au>Körber, Thomas</au><au>Koschyk, Dietmar H.</au><au>Chatterjee, Tushar</au><au>Weber, Frank</au><au>Nienaber, Christoph A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2004-12</date><risdate>2004</risdate><volume>11</volume><issue>6</issue><spage>659</spage><epage>666</epage><pages>659-666</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To examine the clinical consequences and/or potential need for postinterventional transposition after stent-graft occlusion of the left subclavian artery (LSA).
Methods:
The records of 171 consecutive patients (128 men; mean age 60.2±13.2 years, range 20–83) undergoing elective stent-graft repair in the thoracic aorta were reviewed to identify intentional endograft coverage of the ostial LSA, as documented by transesophageal echocardiography and/or aortography. Patients were treated for subacute type B dissection, true aneurysm, pseudoaneurysm, or previously operated type A dissection with persistent false lumen flow in the descending aorta. Among the 171 cases, 22 (12.9%) patients were identified with stent-graft occlusion of the LSA.
Results:
A systolic blood pressure differential existed between the right (138.4±14.0 mmHg) and the left (101.8±21.0 mmHg; p<0.05) arms after occlusion of the LSA. No patient showed a malperfusion syndrome during postinterventional hospitalization. During a mean follow-up of 24.0±15.8 months, 15 (68.2%) patients remained completely asymptomatic, with no functional deficit or temperature differential between the arms, while 7 patients reported mild symptoms of a subclavian steal syndrome. However, no patient required any secondary surgical intervention.
Conclusions:
Stent-graft—induced occlusion of the ostial LSA was tolerated by all patients without chronic functional deficit. In the absence of stenotic vertebral and/or carotid arteries and with a documented intact vertebrobasilar system, prophylactic transposition of the LSA is not required prior to intentional stent-graft occlusion of the LSA.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>15620344</pmid><doi>10.1583/04-1311R.1</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of endovascular therapy, 2004-12, Vol.11 (6), p.659-666 |
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| language | eng |
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| subjects | Adult Aged Aged, 80 and over Aneurysm, Ruptured - diagnostic imaging Aneurysm, Ruptured - surgery Angiography Aortic Aneurysm, Thoracic - diagnostic imaging Aortic Aneurysm, Thoracic - surgery Arterial Occlusive Diseases - diagnostic imaging Arterial Occlusive Diseases - etiology Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - methods Cohort Studies Female Follow-Up Studies Hemodynamics - physiology Humans Intraoperative Complications - diagnostic imaging Intraoperative Complications - physiopathology Male Middle Aged Probability Retrospective Studies Risk Assessment Severity of Illness Index Stents - adverse effects Subclavian Artery - diagnostic imaging Subclavian Artery - physiopathology Treatment Outcome |
| title | Intentional Occlusion of the Left Subclavian Artery during Stent-Graft Implantation in the Thoracic Aorta: Risk and Relevance |
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