{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:42:12Z","timestamp":1793965332629,"version":"4.8.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Coverage of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) increases the risk of major adverse events (MAEs). In\u00a0situ laser\u2010assisted fenestration allows for LSA revascularization in both elective and urgent settings, yet its safety and efficacy lack robust multicenter data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">LLTEVAR (LSA Revascularization With Laser\u2010Assisted Fenestration During TEVAR) was a prospective, single\u2010arm, multicenter study that enrolled patients with acute complicated or high\u2010risk acute TBAD. The primary safety end point was freedom from composite MAEs (mortality, stroke, myocardial infarction, paraplegia, type Ia endoleak, and retrograde aortic dissection\/intramural hematoma) within 30\u2009days after the procedure. Univariate and multivariable analyses identified risk factors for composite MAEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 100 patients (mean age, 60.5\u00b112.6\u2009years) were enrolled at 5 vascular centers between July 2018 and September 2021. The technical success rate of LSA fenestration was 98.0% (98\/100). The 30\u2010day primary safety end point was 86.0%. Complicated TBAD (OR, 4.04; 95% CI, 1.05\u201315.59;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.04) and type II\/III aortic arch (OR, 4.61; 95% CI, 1.18\u201317.95;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03) were significantly associated with a higher risk of composite MAEs within 30\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">In situ laser\u2010assisted fenestration for LSA revascularization during TEVAR demonstrates favorable procedural success and acceptable short\u2010term outcomes in patients with acute TBAD. However, periprocedural MAEs remain a critical consideration, particularly in those with complicated TBAD with type II\/III aortic arch anatomy. Further studies with comparative groups and long\u2010term follow\u2010up are warranted to validate these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT03845829.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041720","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T10:51:35Z","timestamp":1765363895000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Left Subclavian Artery Revascularization With In\u00a0Situ Laser Fenestration During Thoracic Endovascular Aortic Repair for Acute Complicated or High\u2010Risk Type B Aortic Dissection: Results of the LLTEVAR\u00a0Trial"],"prefix":"10.1161","volume":"14","author":[{"given":"Zhiyou","family":"Peng","sequence":"first","affiliation":[{"name":"Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]},{"name":"Vascular Center of Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Liang","sequence":"additional","affiliation":[{"name":"Taizhou Municipal Hospital","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Fengcheng Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Qiu","sequence":"additional","affiliation":[{"name":"Shanghai 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