'chimney stent graft for left subclavian artery preservation during thoracic endograft placement' andre ramdon, mbbs, ramkrishna patel, md, jeffrey hnath, md, chin-chin yeh, md, and r.Clement darling iii, md, albany, ny.A retrospective review of a single vascular surgery registry between february 2011 and september 2017 was performed of all left subclavian revascularization during elective tevar.Arch reconstructions involving more than just the left subclavian artery were excluded.Indications, demographics, procedural details, and outcomes were analyzed using standard statistical analysis.There was one type ia or gutter leak detected few months after the study completion date (10 months after implantation) resulting from foreshortening of the vbx stent.The balloon-expandable 7-mm stent was ballooned to 8 mm during the initial case without any evidence of endoleak.In retrospect, the largest portion of the implanted vessel measured 11 mm.Because the stent co-opted to the native vessel, it lost some of the overlap with the tevar and hence the endoleak.This was treated with extension and redilation to appropriate size, with continued patency of the left vertebral artery.
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