Scallops, fenestrations, CHIMPS, and other monkey business
The coverage of branch vessels during thoracic endovascular aortic repair (TEVAR) with resultant end-organ ischemia is a limitation of endograft technology. Although coverage of the left subclavian artery (LSA) initially was thought to be safe (zone 2 TEVAR), experience has shown that LSA ischemia comes at the cost of permanent stroke and spinal cord injury and reversible complications of arm claudication and vertebrobasilar ischemia. Preserving flow to the LSA in the acute setting remains a clinical dilemma because the emergency nature of the procedure often precludes time-consuming efforts to preserve LSA flow.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: S. Chris Malaisrie Tags: Editorial commentary Source Type: research