{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:42:15Z","timestamp":1793965335066,"version":"4.8.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To evaluate the results of isolated left subclavian artery in-situ fenestration (ISF) during \u2018zone 2\u2019 thoracic endovascular aortic repair (TEVAR) using a new adjustable needle puncturing device system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>It is a multicentre, retrospective, physician-initiated cohort study of patients treated from 28 July 2021 to 3 April 2024. Inclusion criteria were isolate left subclavian artery revascularization for elective or urgent\/emergent \u2018zone 2\u2019 TEVAR. The primary outcome was technical success and freedom from ISF TEVAR-related reintervention or endoleak.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We treated 50 patients: 28 (56.0%) atherosclerotic thoracic aneurysms, 12 (24.0%) type B aortic dissection and 10 (20.0%) penetrating aortic ulcers. Elective intervention was carried out in 46 (92.0%) cases. ISF was successful in all cases, with a procedural primary technical success in 47 (94.0%) cases. The median time of intervention was 184\u2009min (interquartile range 135\u2013220) with a median fenestration time of 20\u2009min (interquartile range 13\u201335). Operative mortality did not occur. We observed 1 case of spinal cord ischaemia and 2 cases of bilateral posterior non-disabling stroke. Mortality at 30\u2009days occurred in 1 (2.0%) patient (not aorta-related). The median follow-up was 4\u2009months (interquartile range 1\u201312.25). Bridging stent graft patency was 100% with no ISF-related endoleak. ISF-related reintervention was never required<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>ISF TEVAR using the Ankura\u2122-II device with the self-centring adjustable needle system showed high technical success, promising stability and stable aortic-related outcomes. Owing to these results, it represents a safe and effective alternative for standard \u2018zone 2\u2019 TEVAR.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae332","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T14:27:05Z","timestamp":1725978425000},"source":"Crossref","is-referenced-by-count":12,"title":["Preliminary experience of the isolate left subclavian artery <i>in-situ<\/i> fenestration during \u2018zone 2\u2019 thoracic endovascular aortic repair"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-4658","authenticated-orcid":false,"given":"Gabriele","family":"Piffaretti","sequence":"first","affiliation":[{"name":"Vascular Surgery\u2014Department of Medicine and Surgery, University of Insubria School of Medicine and ASST Settelaghi University Teaching Hospital , 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