Vertebral artery course variation leading to an insufficient proximal anchoring area for thoracic endovascular aortic repair

Vascular. 2022 Nov 15:17085381221140319. doi: 10.1177/17085381221140319. Online ahead of print.

Abstract

Backgrounds: We aimed to demonstrate the feasibility of thoracic endovascular aortic repair for type B aortic dissection in patients with an insufficient proximal anchoring area due to the vertebral artery originating from the aortic arch.

Methods: In this study, we report two patients with type B aortic dissection who were complicated with left vertebral artery course variation. Specifically, the left vertebral artery originated from the aortic arch. In these patients, the anchoring area (<15 mm) was not sufficient between the left vertebral artery and the ruptured aortic dissection.

Result: We reconstructed the left vertebral artery during horacic endovascular aortic repair. Both patients recovered well and were discharged without any adverse events.

Conclution: Our experience shows that horacic endovascular aortic repair is feasible in patients with type B aortic dissection who have an insufficient proximal anchoring area due to the left vertebral artery originating from the aortic arch.

Keywords: thoracic endovascular aortic repair; variation; vertebral artery.