How I do it: Established and novel methods for left subclavian revascularization with thoracic endovascular aortic repair

Abstract

Left subclavian artery revascularization at the time of thoracic endovascular aortic repair has been the subject of discussion for over a decade. Contemporary viewpoints suggest that revascularization should be performed where possible to decrease the risk of perioperative stroke, spinal cord ischemia, and, to a lesser degree, loss of upper extremity function. In this article, we present traditional methods as well as descriptions of newer options and technology for preservation of left subclavian artery flow during thoracic endovascular aortic repair.

Keywords

• Subclavian artery revascularization
• Thoracic branched endoprothesis
• Carotid to subclavian bypass
• Subclavian transposition
• Laser fenestration