Related Experiment Video

Updated: May 23, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
04:56

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm

Published on: August 1, 2025

Can the Left Subclavian Artery be Safely Covered During Endovascular Repair of the Descending Thoracic Aorta?

Ourania Preventza1, Grayson H Wheatley, James Williams

  • 1From the Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix, AZ.

Innovations (Philadelphia, Pa.)
|March 23, 2012
PubMed

Insights

Routine preoperative carotid-subclavian bypass is not necessary for most patients undergoing endovascular repair of the descending thoracic aorta (DTA). This approach is only needed for select cases, such as those with specific bypass grafts or vertebral artery disease.

Area of Science:

  • Vascular Surgery
  • Thoracic Endografting
  • Aortic Pathology Management

Background:

  • Preoperative carotid-subclavian bypass is often recommended before endovascular repair of the descending thoracic aorta (DTA).
  • This practice aims to mitigate risks associated with left subclavian artery (LSA) coverage during DTA endografting.

Purpose of the Study:

  • To evaluate the necessity of routine preoperative carotid-subclavian bypass in patients undergoing DTA endografting.
  • To analyze the outcomes of LSA coverage during thoracic endovascular aortic repair (TEVAR).

Main Methods:

  • A retrospective review of 255 patients treated with endoluminal grafts (ELG) for DTA repair between 2000 and 2005.
  • Analysis of LSA coverage (complete or partial) and the need for carotid-subclavian bypass or transposition.

Main Results:

  • Complete LSA coverage occurred in 27.8% of patients, and partial coverage in 18.4%.
  • Only 5.9% of patients had a preoperative bypass, with one patient (1.8%) requiring a postoperative bypass for claudication.
  • No major complications were reported due to LSA coverage in the absence of a preoperative bypass.

Conclusions:

  • Routine preoperative carotid-subclavian bypass is not essential for all patients undergoing DTA endovascular repair.
  • This procedure should be reserved for select individuals, including those with a patent left internal mammary artery graft or contralateral vertebral artery disease.
Abstract

More Related Videos

Novel and Innovative Hybrid Technique for Type A Aortic Dissection06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Related Concept Videos

The Arch of Aorta01:10

The Arch of Aorta

The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
Thoracic Aorta01:15

Thoracic Aorta

The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...