Document Detail


Advantage of a precurved fenestrated endograft for aortic arch disease: Simplified arch aneurysm treatment in Japan 2010 and 2011.
MedLine Citation:
PMID:  23410765     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: We evaluated the results of our previous study investigating a precurved fenestrated endograft treatment for thoracic aortic aneurysms and aortic dissection extended to the aortic arch.
METHODS: From February 2010 to December 2011 at 35 Japanese centers, 383 patients (mean age, 75.7 ± 9.4 years) who required stent-graft landing in the aortic arch were treated with a precurved fenestrated endograft. The device has 19 3-dimensional curved stent skeleton types similar to aortic arch configurations and 8 graft fenestration types and is 24 to 44 mm in diameter and 16 to 20 cm long. The endografts were fabricated according to preoperative 3-dimensional computed tomographic images.
RESULTS: Technical and initial successes were achieved in 380 and 364 cases, respectively. Device proximal end was at zones 0 to 2 in 363, 15, and 2 patients, respectively. Lesions' proximal end ranged from zone 0 to 3 in 16, 125, 195, and 44 patients, respectively. The mean operative and fluoroscopic times were 161 ± 76 and 26 ± 13 min, respectively. The complications included stroke (7 patients), permanent paralysis (3), and perioperative death (6). No branch occlusion or proximal migration of the device occurred during follow-up.
CONCLUSIONS: A precurved fenestrated endograft for endovascular repair in aortic arch disease rendered catheter manipulation simple and minimized operative complication risks. Although most patients had inadequate proximal landing zone and severely angled complex configuration, low mortality and morbidity and satisfactory clinical success were early outcomes, suggesting that this simplified treatment may be effective for aortic arch disease.
Authors:
Yoshihiko Yokoi; Takashi Azuma; Kenji Yamazaki
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Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  145     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S103-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: kappa1231fumi@gmail.com.
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