Abstract:Objective To compare the therapeutic effects of chimney technique for reconstruction and simple occlusion of left subclavian artery (LSA) in the endovascular treatment of aortic dissection with insufficient proximal anchorage zone. Methods A total of 56 patients with aortic dissection with insufficient proximal anchorage zone treated with thoracic endovascular aortic repair (TEVAR) in Heze Municipal Hospital from January 2016 to March 2019 were studied retrospectively.According to the different treatments for LSA,the patients were divided into simple occlusion group (occlusion group,n=30) and chimney technique reconstruction group (reconstruction group,n=26).LSA was reconstructed with chimney technique after being occluded by aortic stent graft in reconstruction group,and LSA was only occluded by the stent graft without reconstructing in occlusion group.The related indexes of operation and postoperative follow-up for 12 months were compared between two groups. Results Compared with reconstruction group,the rates of proximal type Ⅰ endoleak after aortic stent release and after balloon dilatation decreased significantly in occlusion group (P<0.05).The incidence of proximal type Ⅰ endoleak was similar in two groups during the follow-up period,and there were no significant differences in the complete thrombosis rate of the thoracic aortic false lumen and in the results of postoperative true lumen and false lumen remodeling.The higher incidences left upper limb weakness and dizziness in occlusion group compared with reconstruction group (P<0.05). Conclusion In the treatment of aortic dissection with insufficient anchorage area,both simple occlusion and chimney technique reconstruction with occlusion for LSA have the same proximal type Ⅰ endoleak rate and aortic remodeling outcome.Chimney reconstruction with occlusion has lower incidences of left upper limb weakness and dizziness during follow-up period.