HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Taijiro Sueda Kazumasa Orihashi Kenji Okada Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sueda, T. Articles by Hamamoto, M. Search for Related Content PubMed PubMed Citation Articles by Sueda, T. Articles by Hamamoto, M. Related Collections Cerebral protection Great vessels Minimally invasive surgery

Eur J Cardiothorac Surg 2004;25:716-721
© 2004 Elsevier Science NL

Successful shrinkage of distal arch and proximal descending aortic aneurysm after transaortic endovascular stent-grafting

Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan

Received 19 October 2003; received in revised form 11 December 2003; accepted 16 December 2003.

^* Corresponding author. Tel.: +81-82-257-5215; fax: +81-82-257-5219
e-mail: sueda{at}hiroshima-u.ac.jp

Objectives: Although endovascular stent-grafting is available for atherosclerotic thoracic aneurysms, it is unknown whether the excluded thrombosed aneurysms shrink. We evaluated serial changes in distal aortic arch or proximal descending aortic aneurysms excluded space after transaortic stent-grafting. Methods: Thirty-four patients with true distal aortic arch or proximal descending thoracic aortic aneurysms were treated by stent-grafts introduced via proximal arch aortic incisions. Follow-up included computed tomographs (CT) every 6 months in 31 patients. The maximum dimensions for excluded space and aneurysmal diameters were measured and evaluated to determine whether the aneurysmal space had decreased or shrunken following this alternative procedure. Results: Two hospital deaths (5.9%) were caused by a cerebral embolism and a peri-operative myocardial infarction. Another case died from pneumonia a year after surgery. Thirty-one cases (91%) survived during follow-up, but one case suffered from paraplegia (2.9%). The follow-up period ranged from 10 to 72 months (average 39.3±27.2 months). There were no aneurysmal ruptures during follow-up. Post-operative serial CTs showed a disappearance or a significant shrinkage of the excluded aneurysmal space in 30 of the 31 cases (97%); one case suffered endoluminal leakage. Conclusions: Transaortic endovascular stent-grafting is feasible for distal aortic arch or proximal descending aortic aneurysms. The excluded aneurysmal space disappears or shrinks after successful stent-graft placement.

Key Words: Transaortic stent-grafting • Endoluminal stent-grafting • Distal aortic arch aneurysm