{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:06:14Z","timestamp":1785150374049,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundations of China","doi-asserted-by":"publisher","award":["82000430"],"award-info":[{"award-number":["82000430"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To present our experience of preserving the isolated left vertebral artery (ILVA) with physician-modified fenestration (PM-F) or <jats:italic>in situ<\/jats:italic> fenestration (ISF) during thoracic endovascular aortic repair (TEVAR) for aortic pathologies involving aortic arch.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single-center, retrospective, observational cohort study. Between June 2016 and December 2021, 9 patients (8 men; median age 60.0 years old) underwent TEVAR with ILVA reconstruction (PM-F, <jats:italic>n<\/jats:italic>\u2009=\u20096; ISF, <jats:italic>n<\/jats:italic>\u2009=\u20093) were identified and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The technical success rate was 100%. No early (&amp;lt;30 days) death occurred. No aortic rupture, major stroke or spinal cord injury was observed. The median follow up was 38.0 (rang: 1.0\u201366.0) months. One death occurred at 56 months, while the reason cannot be identified. No aortic rupture, major stroke or spinal cord injury was observed during follow up. No patient required reintervention. Out of the 22 successfully revascularized target vessels, 2 ILVAs were found occluded in 2 patients at 6 months and 7 months, respectively. However, these two patients were asymptomatic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our initial experience reveals that PM-F or ISF for ILVA preservation was feasible, safe, and effective during TEVAR for complex thoracic aortic pathologies. However, the patency of preserved ILVA should be improved.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1055549","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T13:42:18Z","timestamp":1680183738000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Physician-modified fenestration or in situ fenestration for preservation of isolated left vertebral artery in thoracic endovascular aortic repair"],"prefix":"10.3389","volume":"10","author":[{"given":"Peier","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donglin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziheng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongkun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1016\/j.jtcvs.2015.02.019","article-title":"Atypical aortic arch branching variants: a novel marker for thoracic aortic disease","volume":"149","author":"Dumfarth","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.clinimag.2013.07.008","article-title":"Frequency and imaging findings of variations in human aortic arch anatomy based on multidetector computed tomography data","volume":"37","author":"Celikyay","year":"2013","journal-title":"Clin Imaging"},{"key":"B3","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.jvs.2017.06.097","article-title":"A systematic review and meta-analysis of variations in branching patterns of the adult aortic arch","volume":"68","author":"Popieluszko","year":"2018","journal-title":"J Vasc Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00276-018-1987-3","article-title":"A systematic classification of the vertebral artery variable origin: clinical and surgical implications","volume":"40","author":"Lazaridis","year":"2018","journal-title":"Surg Radiol Anat"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e795","DOI":"10.1097\/MD.0000000000000795","article-title":"Incidence of branching patterns variations of the arch in aortic dissection in Chinese patients","volume":"94","author":"Tapia","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1093\/ejcts\/ezt609","article-title":"Vertebral artery variations in thoracic aortic patients","volume":"46","author":"Ohkura","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1067\/mtc.2002.121673","article-title":"Type A aortic dissection with associated anomaly of the carotid and vertebral vessels","volume":"123","author":"Ad","year":"2002","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/j.jtcvs.2009.02.041","article-title":"Is total arch replacement combined with stented elephant trunk implantation justified for patients with chronic stanford type A aortic dissection?","volume":"138","author":"Sun","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"783656","DOI":"10.3389\/fcvm.2021.783656","article-title":"Transposition of isolated left vertebral artery in hybrid thoracic endovascular aortic repair","volume":"8","author":"Yang","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1093\/ejcts\/ezy313","article-title":"Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European association for cardio-thoracic surgery (EACTS) and the European society for vascular surgery (ESVS)","volume":"55","author":"Czerny","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.avsg.2019.03.016","article-title":"A single center experience of in situ needle fenestration of supra-aortic branches during thoracic endovascular aortic repair","volume":"61","author":"Xiang","year":"2019","journal-title":"Ann Vasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.ejvs.2021.10.036","article-title":"Antegrade in situ needle assisted fenestration during endovascular aortic repair for preserving renal arteries","volume":"63","author":"Li","year":"2022","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.ejvs.2017.11.022","article-title":"Favourable outcomes of endovascular total aortic arch repair via needle based in situ fenestration at a mean follow-up of 5.4 months","volume":"55","author":"Shang","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European society of cardiology (ESC)","volume":"35","author":"Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1016\/j.jvs.2010.07.008","article-title":"Society for vascular surgery ad hoc committee on TEVAR reporting standards. Reporting standards for thoracic endovascular aortic repair (TEVAR)","volume":"52","author":"Fillinger","year":"2010","journal-title":"J Vasc Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0140817","DOI":"10.1371\/journal.pone.0140817","article-title":"Completeness of follow-up determines validity of study findings: results of a prospective repeated measures cohort study","volume":"10","author":"von Allmen","year":"2015","journal-title":"PLoS One"},{"key":"B17","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/S0003-4975(10)61048-X","article-title":"Surgical treatment of aneurysms of the transverse aortic arch: experience with 25 patients using hypothermic techniques","volume":"32","author":"Cooley","year":"1981","journal-title":"Ann Thorac Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/ejcts\/ezv242","article-title":"Repair of complicated type B dissection with an isolated left vertebral artery using the stented elephant trunk technique","volume":"49","author":"Zhu","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1016\/j.jtcvs.2019.06.011","article-title":"Transposition of the left vertebral artery during endovascular stent-graft repair of the aortic arch","volume":"159","author":"Piffaretti","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e17159","DOI":"10.1097\/MD.0000000000017159","article-title":"Thoracic endovascular aortic repair in penetrating aortic ulcer combined with isolated left vertebral artery: a case report","volume":"98","author":"Fan","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.jvs.2018.11.052","article-title":"Management of type B aortic dissection with an isolated left vertebral artery","volume":"70","author":"Ding","year":"2019","journal-title":"J Vasc Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.jocn.2010.07.137","article-title":"A multidetector CT angiography study of variations in the circle of willis in a Chinese population","volume":"18","author":"Li","year":"2011","journal-title":"J Clin Neurosci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.athoracsur.2012.07.078","article-title":"Total arch replacement in patients with aortic dissection with an isolated left vertebral artery","volume":"95","author":"Qi","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1016\/j.athoracsur.2005.12.062","article-title":"Total aortic arch replacement in patients with arch vessel anomalies","volume":"81","author":"Suzuki","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.11.007","article-title":"Management of an isolated left vertebral artery on the arch during zone 2-landing thoracic endovascular aortic repair: a multicentre retrospective study","author":"Zhang","year":"","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.ejvs.2017.06.014","article-title":"Mid-term results of chimney and periscope grafts in supra-aortic branches in high risk patients","volume":"54","author":"Pecoraro","year":"2017","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.ejvs.2021.07.017","article-title":"Thoracic endovascular repair for aortic arch pathologies with surgeon modified fenestrated stent grafts: a multicentre retrospective study","volume":"62","author":"Li","year":"2021","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1016\/j.jvir.2020.02.025","article-title":"In situ laser stent graft fenestration of the left subclavian artery during thoracic endovascular repair of type B aortic dissection with limited proximal landing zones: 5-year outcomes","volume":"31","author":"Zhao","year":"2020","journal-title":"J Vasc Interv Radiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1007\/s00595-019-01917-3","article-title":"Current status of endovascular treatment for thoracoabdominal aortic aneurysms","volume":"50","author":"Baba","year":"2020","journal-title":"Surg Today"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1055549\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T13:42:20Z","timestamp":1680183740000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1055549\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":29,"alternative-id":["10.3389\/fcvm.2023.1055549"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1055549","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,30]]},"article-number":"1055549"}}