1. Contemporary outcomes after treatment of aberrant subclavian artery and Kommerell's diverticulum
- Author
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Bath, Jonathan, D'Oria, Mario, Rogers, Richard T., Colglazier, Jill J., Braet, Drew J., Coleman, Dawn M., Scali, Salvatore T., Back, Martin R., Magee, Gregory A., Plotkin, Anastasia, Dueppers, Philip, Zimmermann, Alexander, Affi, Rana O., Khan, Sophia, Zarkowsky, Devin, Dyba, Gregory, Soult, Michael C., Mani, Kevin, Wanhainen, Anders, Setacci, Carlo, Lenti, Massimo, Kabbani, Loay S., Weaver, Mitchelle R., Bissacco, Daniele, Trimarchi, Santi, Stoecker, Jordan B., Wang, Grace J., Szeberin, Zoltan, Pomozi, Eniko, Moffatt, Clare, Gelabert, Hugh A., Tish, Shahed, Hoel, Andrew W., Cortolillo, Nicholas S., Spangler, Emily L., Passman, Marc A., De Caridi, Giovanni, Benedetto, Filippo, Zhou, Wei, Abuhakmeh, Yousef, Newton, Daniel H., Liu, Christopher M., Tinelli, Giovanni, Tshomba, Yamume, Katoh, Airi, Siada, Sammy S., Khashram, Manar, Gormley, Sinead, Mullins, John R., Schmittling, Zachary C., Maldonado, Thomas S., Politano, Amani D., Rynio, Pawel, Kazimierczak, Arkadiusz, Gombert, Alexander, Jalaie, Houman, Spath, Paolo, Gallitto, Enrico, Czerny, Martin, Berger, Tim, Davies, Mark G., Stilo, Francesco, Montelione, Nunzio, Mezzetto, Luca, Veraldi, Gian Franco, Lepidi, Sandro, Lawrence, Peter, Woo, Karen, Bath, Jonathan, D'Oria, Mario, Rogers, Richard T., Colglazier, Jill J., Braet, Drew J., Coleman, Dawn M., Scali, Salvatore T., Back, Martin R., Magee, Gregory A., Plotkin, Anastasia, Dueppers, Philip, Zimmermann, Alexander, Affi, Rana O., Khan, Sophia, Zarkowsky, Devin, Dyba, Gregory, Soult, Michael C., Mani, Kevin, Wanhainen, Anders, Setacci, Carlo, Lenti, Massimo, Kabbani, Loay S., Weaver, Mitchelle R., Bissacco, Daniele, Trimarchi, Santi, Stoecker, Jordan B., Wang, Grace J., Szeberin, Zoltan, Pomozi, Eniko, Moffatt, Clare, Gelabert, Hugh A., Tish, Shahed, Hoel, Andrew W., Cortolillo, Nicholas S., Spangler, Emily L., Passman, Marc A., De Caridi, Giovanni, Benedetto, Filippo, Zhou, Wei, Abuhakmeh, Yousef, Newton, Daniel H., Liu, Christopher M., Tinelli, Giovanni, Tshomba, Yamume, Katoh, Airi, Siada, Sammy S., Khashram, Manar, Gormley, Sinead, Mullins, John R., Schmittling, Zachary C., Maldonado, Thomas S., Politano, Amani D., Rynio, Pawel, Kazimierczak, Arkadiusz, Gombert, Alexander, Jalaie, Houman, Spath, Paolo, Gallitto, Enrico, Czerny, Martin, Berger, Tim, Davies, Mark G., Stilo, Francesco, Montelione, Nunzio, Mezzetto, Luca, Veraldi, Gian Franco, Lepidi, Sandro, Lawrence, Peter, and Woo, Karen
- Abstract
Objective: Aberrant subclavian artery (ASA) and Kommerell's diverticulum (KD) are rare vascular anomalies that may be associated with lifestyle-limiting and life-threatening complications. The aim of this study is to report contemporary outcomes after invasive treatment of ASA/KD using a large international dataset. Methods: Patients who underwent treatment for ASA/KD (2000-2020) were identified through the Vascular Low Frequency Disease Consortium, a multi-institutional collaboration to investigate uncommon vascular disorders. We report the early and mid-term clinical outcomes including stroke and mortality, technical success, and other operative outcomes including reintervention rates, patency, and endoleak. Results: Overall, 285 patients were identified during the study period. The mean patient age was 57 years; 47% were female and 68% presented with symptoms. A right-sided arch was present in 23%. The mean KD diameter was 47.4 mm (range, 13.0-108.0 mm). The most common indication for treatment was symptoms (59%), followed by aneurysm size (38%). The most common symptom reported was dysphagia (44%). A ruptured KD was treated in 4.2% of cases, with a mean diameter of 43.9 mm (range, 18.0-100.0 mm). An open procedure was performed in 101 cases (36%); the most common approach was ASA ligation with subclavian transposition. An endovascular or hybrid approach was performed in 184 patients (64%); the most common approach was thoracic endograft and carotid-subclavian bypass. A staged operative strategy was employed more often than single setting repair (55% vs 45%). Compared with endovascular or hybrid approach, those in the open procedure group were more likely to be younger (49 years vs 61 years; P < .0001), female (64% vs 36%; P < .0001), and symptomatic (85% vs 59%; P < .0001). Complete or partial symptomatic relief at 1 year after intervention was 82.6%. There was no association between modality of treatment and symptom relief (open 87.2% vs endovascular o
- Published
- 2023
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