TEVAR can be successfully performed in patients with thoracic aneurysms near the LSA origin and a patent LITA-LAD graft by utilizing LSA transposition and protective bypass.
May warrant consideration in select cases with patent LITA-LAD graft; leaves open need for prospective validation of safety and durability.
Thoracic endovascular aortic repair (TEVAR) is a safe and reliable technique utilized in the treatment for aortic aneurysms. However, in up to 40% of patients, devices are typically placed over the left subclavian artery (LSA) origin. In this report, we present a case of a successful TEVAR procedure following the transposition of the LSA with protective carotico-axillary/carotid bypass in a patient with a patent left internal thoracic artery (LITA)-left anterior descending (LAD) coronary artery bypass graft and right internal carotid artery (ICA) occlusion.
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Babić et al. (2012) studied this question.
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