Abstract：Objective: To investigate the effect of left subclavian artery bypass technique on neurological complications after aortic dissection endovascular exclusion. Methods: The clinical data of 43 patients with Stanford type B aortic dissection (TBAD) admitted to our hospital from June 2016 to June 2018 were retrospectively analyzed. The patients were divided into group A (n=23) and group B (n=20) according to the different surgical methods; group A received left subclavian artery bypass technology combined with aortic dissection endovascular exclusion,and group B received chimney stent implantation combined with aortic dissection endovascular exclusion. The operation conditions,postoperative complications during hospitalization,and death rate within 2 years of follow-up were compared between the two groups. Results: There was no significant difference in age,gender,medical history and dissection stage between the two groups (P>0.05). The operation time of group A was shorter than that of group B (P<0.05),and the amount of intraoperative blood loss was less than that of group B (P<0.05),while there was no significant difference in the rate of intraoperative leakage and success rate between group A and group B (P>0.05). The incidences of internal leakage and spinal cord ischemia in group A were lower than those in group B (P<0.05),while the incidences of cerebral infarction and left upper limb ischemia in group A were not significantly different from those in group B (P>0.05). After 2 years of follow-up,up to June 2020,there were 2 deaths in group A and 5 deaths in group B,there was no significant difference in mortality between group A and group B (χ2= 1.062,P=0.303). Conclusion: Compared with chimney stent implantation combined with aortic dissection endovascular exclusion,the implementation of left subclavian artery bypass technology combined with aortic dissection endovascular exclusion can significantly shorten the operation time,reduce intraoperative bleeding,reduce the incidences of leakage and spinal cord ischemia during the hospitalization in patients with TBAD. There was no significant difference in intraoperative leakage rate,success rate of operation,incidence of cerebral infarction,incidence of left upper limb ischemia,mortality and so on between the two groups.
2021, Vol. 27 
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