{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T02:32:27Z","timestamp":1769308347034,"version":"3.49.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the in-hospital and later outcomes of thoracic endovascular aortic repair (TEVAR) for type B intramural hematoma (TBIMH) combined with an aberrant subclavian artery (aSCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the period from January 2014 to December 2020, 12 patients diagnosed with TBIMH combined with aSCA and treated by TEVAR were enrolled in this retrospective cohort study, including 11 patients with the aberrant right subclavian artery (ARSA) and 1 with an aberrant left subclavian artery (ALSA). A handmade fenestrated stent-graft or chimney stent or hybrid repair was performed when the proximal landing zone was not enough.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of all the patients was 59.2 \u00b1 7.6 years, and 66.7% of patients were men. There were 4 patients with Kommerell's diverticulum (KD). The procedures in all 12 patients were technically successful. There was one case each of postoperative delirium, renal impairment, and type IV endoleak after TEVAR. During follow-up, 1 patient died of acute pancreatitis 7 months after TEVAR. The overall survival at 1, 3, and 5 years for the patients was 90.9, 90.9, and 90.9%, respectively. KD was excluded in 2 patients, and the handmade fenestrated stent-graft was applied in the other 2 patients to preserve the blood flow of the aSCA. No neurological complications developed and no progression of KD was observed during the follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thoracic endovascular aortic repair for patients with aSCA and TBIMH is promising. When KD was combined, we could exclude KD or preserve the blood flow of aSCA with regular follow-up for the diverticulum according to the size of the KD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2021.813970","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T05:00:29Z","timestamp":1644555629000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Thoracic Endovascular Aortic Repair for Aberrant Subclavian Artery and Stanford Type B Aortic Intramural Hematoma"],"prefix":"10.3389","volume":"8","author":[{"given":"Xia","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daoquan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ningxin","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongmin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1016\/j.jvs.2020.01.042","article-title":"Association of aberrant subclavian arteries with aortic pathology and proposed classification system","volume":"72","author":"Plotkin","year":"2020","journal-title":"J Vasc Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.athoracsur.2015.02.027","article-title":"Evolution in the management of aberrant subclavian arteries and related Kommerell diverticulum","volume":"100","author":"van Bogerijen","year":"2015","journal-title":"Ann Thorac Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/j.jtcvs.2013.02.063","article-title":"Hybrid repair of Kommerell diverticulum","volume":"147","author":"Idrees","year":"2014","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"346","DOI":"10.5090\/kjtcs.20.071","article-title":"Surgical outcomes of Kommerell diverticulum","volume":"53","author":"Kwon","year":"2020","journal-title":"Korean J Thorac Cardiovasc Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1161\/CIRCULATIONAHA.112.000483","article-title":"Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study","volume":"127","author":"Howard","year":"2013","journal-title":"Circulation."},{"key":"B6","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1093\/eurheartj\/ehx319","article-title":"Acute aortic syndromes: diagnosis and management, an update","volume":"39","author":"Bossone","year":"2018","journal-title":"Eur Heart J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1016\/j.jvir.2019.02.001","article-title":"Midterm outcomes of endovascular repair for stanford type B aortic dissection with aberrant right subclavian artery","volume":"30","author":"Zhang","year":"2019","journal-title":"J Vasc Interv Radiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.ejvs.2017.09.014","article-title":"Morphology and outcomes of total endovascular treatment of type B aortic dissection with aberrant right subclavian artery","volume":"54","author":"Zhou","year":"2017","journal-title":"Eur J Vasc Endovasc Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1177\/15385744211005664","article-title":"Endovascular aortic repair with castor single-branched stent-graft in treatment of acute type B aortic syndrome and aberrant right subclavian artery","volume":"55","author":"Pang","year":"2021","journal-title":"Vasc Endovasc Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1148\/rg.2021200055","article-title":"Chest CT angiography for acute aortic pathologic conditions: pearls and pitfalls","volume":"41","author":"Ko","year":"2021","journal-title":"Radiographics."},{"key":"B11","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. 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