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

Area of Science:

• Vascular Surgery
• Cardiovascular Interventions
• Thoracic Aortic Disease

Background:

• Left subclavian artery (LSAA) revascularization during thoracic endovascular aortic repair (TEVAR) is a debated topic.
• Current evidence suggests LSAA revascularization may mitigate perioperative stroke, spinal cord ischemia, and upper extremity dysfunction.
• Optimal management strategies for LSAA coverage during TEVAR remain under investigation.

Purpose of the Study:

• To review traditional and novel techniques for LSAA revascularization during TEVAR.
• To discuss the benefits of preserving LSAA flow in TEVAR procedures.
• To provide an overview of current options for LSAA management.

Main Methods:

• Review of existing literature on LSAA revascularization and TEVAR.
• Description of established surgical and endovascular revascularization techniques.
• Presentation of emerging technologies and approaches for LSAA flow preservation.

Main Results:

• LSAA revascularization is associated with reduced risks of stroke and spinal cord ischemia.
• Various methods exist, ranging from traditional bypass to advanced endovascular techniques.
• The choice of method depends on patient anatomy and procedural complexity.

Conclusions:

• Preserving LSAA flow during TEVAR is increasingly favored to improve patient outcomes.
• A range of techniques are available, allowing for tailored approaches.
• Further research may refine indications and techniques for LSAA revascularization.