A Challenging Treatment for Aortic Arch Aneurysm With Fenestrated Stent Graft

Yasuda, Kôichi; Kimura, Naoyuki; Hori, Daijiro; Yamaguchi, Atsushi; Adachi, Hideo

doi:10.1016/j.athoracsur.2017.05.062

Cited by 9 publications

(2 citation statements)

References 23 publications

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“…Also growing in popularity are the fenestrated stents, in which openings are made on the stent to allow blood flow to the aortic arch branches. Both techniques have been used successfully in repair of the aortic arch TAA, 69,[72][73][74][75][76][77] with branched stents having been shown to result in comparable early mortality to that of open repair (4.4% vs 3.3%, respectively; P ¼ .74). 70 It is essential that these stents be custom-made as they require careful planning with imaging.…”

Section: What Is the Future?mentioning

confidence: 99%

Current challenges in open versus endovascular repair of ruptured thoracic aortic aneurysm

Harky

Chan

Wong

et al. 2018

Journal of Vascular Surgery

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A ruptured thoracic aortic aneurysm is considered a surgical emergency; it is often fatal if it is not identified and managed immediately. Since the recognition of this clinical entity, open surgical repair has been the "gold standard" method of management. However, open surgical repair is associated with high morbidity and mortality rates. Among high-risk patients and as an alternative, thoracic endovascular repairs have since transpired, aiming to reduce the morbidity and mortality rates associated with open repair in a number of patients. The results of both treatment options are debatable, yet there is not a full concurrence on the advantages of endovascular repair in comparison to open repair as the gold standard method of managing such emergency cases, particularly ruptures involving the ascending and aortic arch. This literature review aimed to examine current literature evidence for the use of open or endovascular repair in the emergency setting of a ruptured thoracic aortic aneurysm.

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Section: What Is the Future?mentioning

confidence: 99%

Current challenges in open versus endovascular repair of ruptured thoracic aortic aneurysm

Harky

Chan

Wong

et al. 2018

Journal of Vascular Surgery

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“…With advances in instrument technology and the accumulation of clinical experience, endovascular technology for AAPs has made great progress. The branched stent, fenestration stent, and other technologies have been developed [2,[5][6][7][8]. However, challenges remain due to the curved structure of the aortic arch and the need to preserve the important brachiocephalic branches of the arch.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Postoperative Remodeling Characteristics after Modular Inner Branched Stent-Graft Treatment of Aortic Arch Pathologies Using Computational Fluid Dynamics

Zhu

Song

et al. 2023

Bioengineering

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The modular inner branched stent-graft (MIBSG), a novel interventional therapy, has demonstrated good effects in the endovascular treatment of aortic arch pathologies, especially those involving the supra-aortic branches. Nevertheless, the long-term efficacy of the MIBSG and in-depth quantitative evaluation of postoperative outcomes remain to be examined. Moreover, the regularity of postoperative vascular remodeling induced by MIBSG implantation has yet to be explored. To address these questions, we constructed four models (normal, preoperative, 1 week postoperative, and 6 months postoperative) based on a single patient case to perform computational fluid dynamics simulations. The morphological and hemodynamic characteristics, including the velocity profile, flow rate distribution, and hemodynamic parameter distribution (wall shear stress and its derivative parameters), were investigated. After MIBSG implantation, the morphology of the supra-aortic branches changed significantly, and the branch point moved forward to the proximal ascending aorta. Moreover, the curvature radius of the aortic arch axis continued to change. These changes in morphology altered the characteristics of the flow field and wall shear stress distribution. As a result, the local forces exerted on the vessel wall by the blood led to vessel remodeling. This study provides insight into the vascular remodeling process after MIBSG implantation, which occurs as a result of the interplay between vascular morphological characteristics and blood flow characteristics.

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