{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:19:02Z","timestamp":1775060342913,"version":"3.50.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The presence of an isolated left vertebral artery (ILVA) in patients with aortic dissection is a rare and challenging condition. This study aims to determine the optimal management of ILVA in patients with aortic dissection undergoing total arch replacement with frozen elephant trunk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This retrospective study enrolled 94 patients with ILVA and aortic dissection who underwent total arch replacement with frozen elephant trunk. Patients were divided into 3 groups: 18 patients underwent ligation of ILVA, 52 underwent ILVA\u2010left subclavian artery transposition, and 24 underwent ILVA\u2010left common carotid artery transposition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Vertebral artery dominance was left dominant in 10.6%, symmetric in 33.0%, and right dominant in 56.4% of patients. Notably, patients who underwent ligation of ILVA had either symmetric or right\u2010dominant vertebral arteries, with no left\u2010dominant cases. No strokes were observed. Paraplegia\/paraparesis (11.1% versus 11.5% versus 0%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.223), mechanical ventilation time (45 [10\u201361] hour versus 18 [11\u201338] hour versus 15 [11\u201351] hour,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.855), and long\u2010term survival (log\u2010rank\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.419) were comparable among the 3 groups. Follow\u2010up computed tomographic angiography confirmed patency of the left vertebral artery in all patients who underwent ILVA transposition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Ligation of ILVA, ILVA\u2010left subclavian artery transposition, and ILVA\u2010left common carotid artery transposition are all feasible and safe strategies for managing ILVA in patients with aortic dissection undergoing total arch replacement with frozen elephant trunk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041804","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T11:49:16Z","timestamp":1753789756000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Optimal Management of Isolated Left Vertebral Artery in Total Arch Replacement With Frozen Elephant Trunk for Aortic Dissection"],"prefix":"10.1161","volume":"14","author":[{"given":"Sangyu","family":"Zhou","sequence":"first","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bowen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luchen","family":"Wang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, 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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-9052","authenticated-orcid":false,"given":"Cuntao","family":"Yu","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1810-9421","authenticated-orcid":false,"given":"Yaojun","family":"Dun","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3975-2408","authenticated-orcid":false,"given":"Xiaogang","family":"Sun","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, 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