| Objective:To investigate the effect of closed left clavicle artery (LSA) during thoracic endovascular aortic repair
(TEVAR).Methods:608 cases of TEVAR patients in our hospital in February 2005-May 2016 were selected, Among them,there were
396 cases of no-closed LSA, and 212 cases of closed LSA, Analysis of the incidence of perioperative complications such as postoperative
cerebral infarction and paraplegia in patients with TEVAR of closed LSA or no-closed LSA, Followed up and reviewed the data of patients
with cerebral infarction and paraplegia.Results:608 cases of TEVAR patients did not appear severe ischemia of the left upper
limb; The probability of cerebral infarction and paraplegia between no-closed LSA and closed LSA was 0.51%（2/396）VS 0.47%
（1/212）,0.75%（3/396）VS 0.47%（1/212）, the difference was not statistically significant (P＞0.05). Average follow-up (30.5± 3.7)
months long, 509 patients were followed, including the death of 53 cases, follow-up time appear long-term cerebral infarction of 5 cases
(no-closed LSA of 3 cases, closed LSA of 2 cases). During the follow-up period, there were 8 cases of paraplegia preoperative and postoperative,
2 cases died in the seventh day and January respectively after the operation. 1 cases were lost to follow-up, In the rest of the patients,
lower limb muscle strength gradually recovered to more than 4 levels at the end of follow-up.Conclusion:It is feasible to close
LSA in TEVAR operation for TBAD patients, which will not cause acute posterior circulation ischemia, left upper limb can be well tolerated
closed LSA , and does not increase the risk of severe complications such as cerebral infarction and paraplegia. |
