Does external fenestration using a reserved guide wire and a Viabahn-covered stent improve technical success and reduce complications compared to traditional in-situ fenestration in patients with Stanford type B aortic dissection involving the left subclavian artery?
External fenestration with a reserved guide wire and Viabahn-covered stent appears to be a safe and technically successful alternative to traditional in-situ fenestration for Stanford type B aortic dissection involving the left subclavian artery.
This study aimed to evaluate the efficacy of external fenestration using a reserved guide wire and a Viabahn-covered stent in Stanford type B aortic dissection that involves the left subclavian artery. Eight patients with Stanford type B aortic dissection involving the left subclavian artery were treated from March 2023 to May 2024 at Yinzhou People’s Hospital using a reserved guide wire external fenestration and a Viabahn-covered stent. This study compared a novel external fenestration technique (reserved guide wire + Viabahn stent) with traditional in-situ fenestration for Stanford type B aortic dissection involving the left subclavian artery. Clinical data showed that the new method achieved full technical success in vessel reconstruction, with no postoperative deaths, minimal complications, and shorter hospital stay versus the conventional approach. The fenestration complication incidence was also significantly reduced during a follow-up period of 1–3 months. Studies on larger samples can be performed in the future to verify the present results. External stent fenestration with a reserved guide wire demonstrated significant efficacy in treating large-branch artery disease, resulting in substantial improvements in prognosis in terms of complications. Therefore, this technique is worthy of further exploration.
Zhu et al. (Sun,) studied this question.