{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:40:49Z","timestamp":1762508449369},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Thoracic endovascular aortic repair (TEVAR) is the gold standard for surgical management of descending thoracic aortic pathology. Depending on the anatomy, TEVAR often requires deployment across the origin of the left subclavian artery (LSA) to obtain a proximal seal, thus potentially compromising perfusion to the left upper extremity (LUE). However, in most patients this is generally well tolerated without revascularization due to collateralization from the left vertebral artery (LVA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present a complex 59-year-old  Caucasian patient case of TEVAR with a history of prior arch debranching and intraoperative LSA coverage requiring subsequent LSA embolization and emergency take-back for left carotid\u2013subclavian bypass.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The purpose of this case report is to highlight an often overlooked anatomic LVA variant and an atypical, delayed presentation of acute LUE limb ischemia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02772-y","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T23:25:31Z","timestamp":1618442731000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Complex endovascular repair of type B aortic dissection and predicting left arm ischemia: a case report"],"prefix":"10.1186","volume":"15","author":[{"given":"Kevin G","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony N","family":"Grieff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saum","family":"Rahimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2772_CR1","first-page":"234","volume":"3","author":"KG Moulakakis","year":"2014","unstructured":"Moulakakis KG, Mylonas SN, Dalainas I, Kakisis J, Kotsis T, Liapis CD. Management of complicated and uncomplicated acute type B dissection. A systematic review and meta-analysis. Ann Cardiothor Surg. 2014;3:234\u201346.","journal-title":"Ann Cardiothor Surg."},{"key":"2772_CR2","doi-asserted-by":"publisher","first-page":"65S","DOI":"10.1016\/j.jvs.2010.07.003","volume":"52","author":"JS Matsumura","year":"2010","unstructured":"Matsumura JS, Rizvi AZ. Left subclavian artery revascularization: Society for Vascular Surgery\u00ae Practice Guidelines. J Vasc Surg. 2010;52:65S-70S.","journal-title":"J. Vasc. Surg."},{"key":"2772_CR3","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1093\/icvts\/ivy059","volume":"27","author":"E van der Weijde","year":"2018","unstructured":"van der Weijde E, Saouti N, Vos JA, Tromp SC, Heijmen RH. Surgical left subclavian artery revascularization for thoracic aortic stent grafting: a single-centre experience in 101 patients. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"168"}}