Document Detail


The Society for Vascular Surgery Practice Guidelines: management of the left subclavian artery with thoracic endovascular aortic repair.
MedLine Citation:
PMID:  19878791     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Society for Vascular Surgery pursued development of clinical practice guidelines for the management of the left subclavian artery with thoracic endovascular aortic repair (TEVAR). In formulating clinical practice guidelines, the society selected a panel of experts and conducted a systematic review and meta-analysis of the literature. They used the grading of recommendations assessment, development, and evaluation (GRADE) method to develop and present their recommendations. The overall quality of evidence was very low. The committee issued three recommendations. Recommendation 1: In patients who need elective TEVAR where achievement of a proximal seal necessitates coverage of the left subclavian artery, we suggest routine preoperative revascularization, despite the very low-quality evidence (GRADE 2, level C). Recommendation 2: In selected patients who have an anatomy that compromises perfusion to critical organs, routine preoperative LSA revascularization is strongly recommended, despite the very low-quality evidence (GRADE 1, level C). Recommendation 3: In patients who need urgent TEVAR for life-threatening acute aortic syndromes where achievement of a proximal seal necessitates coverage of the left subclavian artery, we suggest that revascularization should be individualized and addressed expectantly on the basis of anatomy, urgency, and availability of surgical expertise (GRADE 2, level C).
Authors:
Jon S Matsumura; W Anthony Lee; R Scott Mitchell; Mark A Farber; Mohammad Hassan Murad; Alan B Lumsden; Roy K Greenberg; Hazim J Safi; Ronald M Fairman;
Publication Detail:
Type:  Journal Article; Practice Guideline; Review    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  50     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2009-11-12     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1155-8     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, University of Wisconsin, Madison, WI 53792, USA. matsumura@surgery.wisc.edu
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MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic / pathology,  physiopathology,  surgery*
Aortic Diseases / pathology,  physiopathology,  surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation,  methods*
Collateral Circulation
Evidence-Based Medicine
Humans
Patient Selection
Prosthesis Design
Regional Blood Flow
Risk Assessment
Stents
Subclavian Artery / pathology,  physiopathology,  surgery*
Surgical Procedures, Elective
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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