Open stent-grafting for aortic arch aneurysm is associated with increased risk of paraplegia

Miyairi, Takeshi; Kotsuka, Yutaka; Ezure, Masahiko; Ōno, Minoru; Morota, Tetsuro; Kubota, Hiroshi; Shibata, Kazuaki; Ueno, Kensuke; Takamoto, Shinichi

doi:10.1016/s0003-4975(02)03602-0

Cited by 46 publications

(29 citation statements)

References 21 publications

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“…(Ramirez-Vargas et al, 2003;Kouchoukos, 1996;Gelsomino et al, 2003;Miyairi et al, 2002;Tominaga et al, 2003;Kazui et al, 2002) The complications that have been reported early as ventricular failure, ventricular arrhythmias and hemorrhage are similar to that reported in our series. In addition other authors report paraplegia, stroke, renal failure, myocardial infarction, and respiratory failure.…”

Section: Thoracoabdominal Aortic Aneurysmssupporting

confidence: 88%

“…(Kouchoukos, 1996;Von Fricken, 2002;Kato et al, 2002) In regards to our experience, the frequency by gender was higher in the male than the female, similar to that reported in the literature. (Ramirez-Vargas et al, 2003;Miyairi et al, 2002;Colombi et al, 1983;Cabrol et al, 1986;David & Feindel, 1992) Early population-based studies have been demonstrated to 5-year survival rate for untreated thoracic aneurysms of only 13 per cent (Bickerstaff et al 1982), and for patients with degenerative aneurysm 3-year survival was 35% (McNamara et al 1978). Usually thoracic aortic aneurysms are asymptomatic.…”

Section: Thoracic Aorta Aneurysmsmentioning

confidence: 99%

See 1 more Smart Citation

Definitions, History and General Considerations Related to the Aortic Aneurysms

Careaga-Reyna¹

2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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Section: Thoracoabdominal Aortic Aneurysmssupporting

confidence: 88%

Section: Thoracic Aorta Aneurysmsmentioning

confidence: 99%

Definitions, History and General Considerations Related to the Aortic Aneurysms

Careaga-Reyna¹

2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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“…A similar method, the introduction of stented graft for a distal anastomosis during aortic arch surgery ('open stent graft' or 'frozen elephant trunk'), has been reported [6,7]. However, spinal cord dysfunction is the most serious complication of this technique [8]. Furthermore, the precise deployment of stent graft is not promising during the circulatory arrest without fluoroscopic guidance.…”

Section: Discussionmentioning

confidence: 99%

Secondary elephant trunk fixation with endovascular stent grafting for extensive/multiple thoracic aortic aneurysm

Matsuda

Tsuji

Sugimoto

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Four patients who underwent secondary elephant trunk fixation by endovascular stent grafting are presented and the advantage of this method to treat multiple/extensive thoracic aortic aneurysm is discussed. In two of them, the elephant trunk installation has been performed at another hospital for extensive aortic aneurysm. In two other patients, the aortic arch replacement and the elephant trunk installation were performed through median sternotomy, initially for multiple aortic lesions, including both arch and descending aorta. No neurological deficit, stroke nor spinal cord injury was encountered during the follow-up period (24-40 months). The diameter of the aneurysms decreased markedly in three patients. In one patient, the aneurysm expanded gradually and type II endoleak was treated by coil embolization. In one patient, who showed marked shrinkage of the aneurysm, the stent graft kinked mildly. Based on the low mortality rate of well-established aortic arch surgery, concomitant elephant trunk installation which was followed by the secondary fixation with endovascular stent grafting might be useful to treat multiple/extensive thoracic aneurysm from distal arch to descending aorta.

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“…1,2 Open stent grafting (OSG) 3 is now commonly used as a new surgical technique to repair a DAA under short-term circulatory arrest via a median sternotomy by using a stent graft (SG). [4][5][6][7][8][9][10][11] However, this surgery requires placement of a large-diameter SG beyond the aortic bend in a narrow operative fi eld, which can result in complications of aortic dissection and embolism. 12 However, treatment of DAA using a SG with a basic Z stent, which is fi xed only at a distal point to adapt to bending, may cause fl exural deformation and stent breakage from the shrunken aneurysm.…”

Section: Introductionmentioning

confidence: 99%

Fully supported open stent grafting applied with a Matsui-Kitamura (MK) stent in treatment of distal arch aneurysm

Midorikawa

Kanno

Ishikawa

2008

Gen Thorac Cardiovasc Surg

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Objective. Our purpose was to examine the use of fully supported open stent grafting (OSG) with a MatsuiKitamura (MK) stent for treatment of distal arch aneurysm (DAA). Methods. Surgery was performed using a newly developed device in seven DAA patients (six men and one woman) from 58 to 86 years of age (mean, 73 years old) from August 2005 to June 2007. The aorta was transected at the arch between bracheocephalic artery and left subclavian artery under circulatory arrest with total cardiopulmonary bypass and selective cerebral perfusion; then the stent grafting (SG) system was inserted and positioned with a 14 Fr. pusher. The SG and a transected edge were then sutured and anastomosed with the arch graft. The surgery was completed by constructing three cerebral branches. Results. The mean SG diameter and length were 34.6 mm (range, 32-38 mm) and 150 mm (120-200 mm), respectively. The mean time of circulatory arrest time and surgery were 41 min (35-55 min) and 358 min (269-450 min), respectively. Simultaneous mitral valve replacement was performed in one patient. All surgeries were completed successfully, and complete thrombosis of the aneurysm was obtained. Paraparesis and respiratory failure occurred in one patient each, and one patient died of brainstem infarction 1 month after surgery.Conclusion. These initial results suggest that the OSG method is a useful surgical procedure for the treatment of DAA.

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Open stent-grafting for aortic arch aneurysm is associated with increased risk of paraplegia

Cited by 46 publications

References 21 publications

Definitions, History and General Considerations Related to the Aortic Aneurysms

Definitions, History and General Considerations Related to the Aortic Aneurysms

Secondary elephant trunk fixation with endovascular stent grafting for extensive/multiple thoracic aortic aneurysm

Fully supported open stent grafting applied with a Matsui-Kitamura (MK) stent in treatment of distal arch aneurysm

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