Neurological complications after thoracic endovascular aortic repair. Does the left subclavian artery coverage without r
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(2019) 14:5
RESEARCH ARTICLE
Open Access
Neurological complications after thoracic endovascular aortic repair. Does the left subclavian artery coverage without revascularization increase the risk of neurological complications in patients after thoracic endovascular aortic repair? Dariusz Janczak1, Agnieszka Ziomek1,2, Jakub Kobecki2, Maciej Malinowski1, Kornel Pormańczuk2,3 and Mariusz Chabowski2,3*
Abstract Introduction: One of the most severe complications after TEVAR is ischemic stroke and spinal cord ischemia (SCI) resulting in severe disability. These complications can be fatal up to 30% of cases, so it is very important to define risk factors associated with the occurrence of such events. The aim of this study was to define the causes and risk factors associated with the occurrence of neurological complications in patients after TEVAR. Materials and methods: We performed a retrospective analysis of 51 patients undergoing TEVAR in the Department of Vascular Surgery of Military Teaching Hospital in Wroclaw between 2014 and 2017. In 18 patients LSA coverage was managed without revascularization (35.29%), and in 33 patients LSA remained uncovered (64.71%). Results: We did not find any statistically significant difference in the incidence of stroke and spinal cord ischemia in patients with covered and uncovered LSA (stroke p = 0.37, SCI p = 0.58). In the group of patients with covered and uncovered LSA, we did not find any significant differences in the incidence of additional comorbidities such as obesity, ischemic heart disease, hypertension or previous stroke. Conclusions: There is no difference in stroke and SCI occurrence between patients with covered and uncovered LSA. Although there are many studies analysing the risk of such complications, there is no specific consensus regarding the treatment of LSA coverage. Randomised clinical trials on a large group of patients are still needed. Keywords: Thoracic endovascular aortic repair (TEVAR), Left subclavian artery (LSA), Cerebrovascular accident (CVA), Stroke, Spinal cord ischemia (SCI)
* Correspondence: [email protected] 2 Department of Surgery, 4th Military Teaching Hospital, 5 Weigla street, 50-981, Wroclaw, Poland 3 Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618, Wroclaw, Poland Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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