{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:36:56Z","timestamp":1791045416656,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,7,29]],"date-time":"2015-07-29T00:00:00Z","timestamp":1438128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,7,29]],"date-time":"2015-07-29T00:00:00Z","timestamp":1438128000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This single\u2010center study assessed left subclavian artery (LSA) revascularization management and morbidity and mortality of LSA coverage outcomes during elective thoracic endovascular aortic repair (TEVAR) for distal arch aneurysms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between July 2006 and June 2014, 178 patients underwent TEVAR (zone 2 + 3) for distal arch aneurysms. TEVAR with LSA coverage (zone 2) was performed in 121 patients (68.0 %). Multivariate analysis was performed to determine factors associated with perioperative cerebral infarction (CI) and postoperative endoleak (EL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Technical success was achieved in 96.7 %. LSA coil embolization was performed in 72.7 %. Subclavian artery crossover bypass was required in 9.1 %. Perioperative complications were CI (6.6 %) and paraplegia (1.7 %). The 30\u2010day mortality rate was 2.5 % (<jats:italic>n<\/jats:italic> = 3). There were significant differences by CI univariate analysis in coverage range (\u2265300\u00a0mm) (<jats:italic>P<\/jats:italic> = 0.003) and shaggy aorta (<jats:italic>P<\/jats:italic> = 0.044). Primary EL occurred in 14.0 % (<jats:italic>n<\/jats:italic> = 17). We found statistically significant difference of primary EL in chronic obstructive pulmonary disease (<jats:italic>P<\/jats:italic> = 0.016), preoperative aneurysm diameter (<jats:italic>P<\/jats:italic> = 0.041), and proximal stent graft diameter (<jats:italic>P<\/jats:italic> = 0.029). Left upper extremity symptoms developed in 5.8 % (<jats:italic>n<\/jats:italic> = 7); vertebrobasilar insufficiency occurred in 4.1 % (<jats:italic>n<\/jats:italic> = 5). Freedom from secondary intervention rates after 1, 3, and 5 years were 96.1, 78.3, and 63.4 %, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our mid\u2010 to long\u2010term results of TEVAR with LSA coverage were generally acceptable. Routine revascularization was not necessary in majority of zone 2 TEVAR. CI occurred in approximately 6 % of the cases, secondary interventions were performed more often for ELs.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-015-3166-6","type":"journal-article","created":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T14:16:52Z","timestamp":1438093012000},"page":"2812-2822","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Clinical Outcomes of Left Subclavian Artery Coverage on Morbidity and Mortality During Thoracic Endovascular Aortic Repair for Distal Arch Aneurysms"],"prefix":"10.1002","volume":"39","author":[{"given":"Takeshi","family":"Baba","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery Jikei University School of Medicine 3\u201025\u20108, Nishi\u2010shinbashi, Minato\u2010ku 105\u20108461 Tokyo 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