体外开窗技术治疗主动脉弓部病变的中期效果OA北大核心CSTPCD

Objective:To investigate the midterm outcomes of thoracic endovascular aortic repair(TEVAR)combined with left subclavian artery(LSA)fenestration for aortic arch diseases.Methods:We retrospectively analyzed the perioperative period and midterm follow-up clinical data of 111 patients who underwent TEVAR combined with LSA fenestration in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021.Results:Overall,the success rate of the surgery was 100％(111/111),the mortality rate within 30 days was 3.6％(4/111).The median postoperative follow-up time was 33.0 months,the all-cause mortality was 6.3％(7/1 11),the aorta-related mortality was 2.7％(3/1 11).Among the main complications,there were 3 patients(2.7％)of cerebrovascular accident,2 patients(1.8％)of paraplegia,1 patient(0.9％)of retrograde type A dissection(RTAD),2 patients(1.8％)of endoleak,and 3 patients(2.7％)of distal stent-induced new entry(dSINE).Four patients(3.6％)underwent the second aortic intervention,of which 3 patients(2.7％)were performed endovascular surgery and 1 patient(0.9％)was performed thoracotomy and artificial vascular replacement.Conclusion:The mid-term outcomes of TEVAR combined with LSA fenestration for aortic arch diseases were within the acceptable range,however,further follow-up results are needed and long-term stability and durability needs to be assessed.In addition,the technical process of fenestration needs to be standardized and unified,and related equipment needs to be further developed.