How I do it: Established and novel methods for left subclavian revascularization with thoracic endovascular aortic repair

Jen Huffman; Jonathan Bath

doi:10.1016/j.jvscit.2023.101367

How I do it: Established and novel methods for left subclavian revascularization with thoracic endovascular aortic repair

J Vasc Surg Cases Innov Tech. 2023 Dec 20;10(2):101367. doi: 10.1016/j.jvscit.2023.101367. eCollection 2024 Apr.

Authors

Jen Huffman¹, Jonathan Bath²

Affiliations

¹ Department of Surgery, University of Missouri, Columbia, MO.
² Division of Vascular Surgery, University of Missouri, Columbia, MO.

Abstract

Left subclavian artery revascularization at the time of thoracic endovascular aortic repair has been the subject of discussion for over a decade. Contemporary viewpoints suggest that revascularization should be performed where possible to decrease the risk of perioperative stroke, spinal cord ischemia, and, to a lesser degree, loss of upper extremity function. In this article, we present traditional methods as well as descriptions of newer options and technology for preservation of left subclavian artery flow during thoracic endovascular aortic repair.

Keywords: Carotid to subclavian bypass; Laser fenestration; Subclavian artery revascularization; Subclavian transposition; Thoracic branched endoprothesis.