Mid-Term Results of Left Carotid-Subclavian Bypass in Patients Undergoing Zone 2 TEVAR

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 37; no. 5; pp. 721 - 726
• Main Authors: İnce, İlker, Altınay, Levent, Huseynov, Senan, Zobu, Melike Şenkal, Şahin, Elif, Ersoy, Özgür, Duvan, İbrahim, Kızıltepe, Uğursay
• Format: Journal Article
• Language: English; Portuguese
• Published: Sao Paulo Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2022
• Subjects: Aortic Aneurysm; CARDIAC & CARDIOVASCULAR SYSTEMS; Carotid Arteries; Coronary vessels; Dissection; Heart surgery; Infections; Intensive care; Ischemia; Low Extremity; Medical imaging; Neurological disorders; Original; Patients; Social sciences; Spinal cord; Statistical analysis; Stroke; Subclavian Artery; Surgeons; SURGERY; Survival analysis; Thoracic Surgery; Tomography; Thoracic Surgery; Carotid Arteries; Subclavian Artery; Aortic Aneurysm; Low Extremity
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2021-0597

Introduction: The aim of this study was to present the mid-term results of patients who had undergone a carotid-subclavian bypass surgery after a thoracic endovascular aortic repair (TEVAR) stent-graft implantation with proximal landing at zone 2 of the aorta. Methods: A total of 66 patients had undergone TEVAR and carotid-subclavian bypass between January 2015 and May 2020 at our clinic. Five of these patients were lost to follow-up, so 61 patients were included in this retrospective study. At follow-up visits, patency of the carotid-subclavian bypass grafts was evaluated with physical examination and radiological imaging. Results: The mean follow-up time was 15.11±12.29 months (ranging from 1 to 56 months). There were 3 (4.91%) in-hospital deaths of patients admitted with bilateral lower limb and visceral malperfusion. There were also 2 (3.27%) deaths unrelated to the procedure. Carotid-subclavian graft occlusion occurred in 3 (4.91%) patients. The occlusion was detected with radiological imaging within a period of 12 to 24 months. The graft patency rate was 100% in the first 12 months. The mean graft patency time (survival) was 52.56±2.10 months. Conclusion: Periprocedural carotid-subclavian bypass surgery with synthetic grafts is a recommended procedure with high patency and acceptably low mortality and morbidity rates in TEVAR.