重建左锁骨下动脉拓展胸主动脉夹层腔内修复术近端锚定区的多种技术选择

Various choices of reconstructing the left subclavicular artery to extend the proximal landing zonethoracic endovascular aortic repair

胸主动脉腔内修复术（TEVAR）已成为治疗StanfordB型主动脉夹层的首选治疗方法。对于近端锚定区不足的StanfordB型主动脉夹层，有时直接覆盖左锁骨下动脉（LSA）会引起相应的并发症。在这种情况下，重建LSA可以拓展近端锚定区使TEVAR得以成功实施。目前重建LSA的方式主要有杂交技术（颈动脉一锁骨下动脉转流等）、烟囱技术（含分支支架技术）及开窗（或开槽）技术等。对于需要重建LSA的主动脉夹层，使用这些技术都是确实有效的，技术的选择和应用需遵循个体化原则。

Thoracic endovascular aortic repair （TEVAR） has become the preferred treatment for Stanford type B aortic dissection. Covered the left subclavian artery （LSA） directly may cause corresponding complications in Stanford type B aortic dissection with unfavourable proximal landing zone. TEVAR can be successfully implemented by reconstructing LSA to expand the proximal landing zone. Currently, the methods of reconstructing LSA mainly include hybridization technology （carotid-subclavian artery transposition）, chimney technology （including branch stent technology ） and fenestration （or slot technology）, etc. These techniques are all valid for aortic dissection that needs to reconstructing LSA. The choices and applications of these techniques should follow the individualized principles.