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When Is Revascularization of an Anomalous Left Vertebral Artery Necessary Prior to Its Coverage? by Benjamin M. Jackson; Alexander S. Fairman is a Medicine article available to read on EtoBox.

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In the current issue, Potter et al present a series of 17 left vertebral-to-carotid artery transpositions in patients with an anomalous left vertebral artery (aLVA) originating from the arch of the aorta undergoing arch procedures and thoracic endovascular aneurysm repairs that would otherwise require sacrifice or coverage of the aLVA. 1 Previously, the largest series of aLVA-to-carotid transpositions performed in the setting of aortic repairs consisted of only six patients. 2 Of note, Bergeur's seminal report of 218 proximal VA transpositions were performed primarily for symptomatic atherosclerotic occlusive disease. The authors present multiple arguments in favor of an aggressive revascularization approach: to prevent risk of posterior stroke, to mitigate the risk of spinal cord ischemia (SCI), and to prevent left upper extremity ischemia. Many of us use aLVA as an indication to perform left subclavian artery (LSA) revascularization prophylactically in patients undergoing thoracic endovascular aneurysm repair or arch procedures wherein the LSA will be sacrificed, and the authors correctly indicate that aLVA transposition to the left carotid artery can be performed at the same tim

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Author

Benjamin M. Jackson; Alexander S. Fairman

Publisher

Elsevier BV

Published

2022

Language

EN

Field

Medicine (Health Sciences)