title: Distal arch aneurysm repair using stent-grafting and ascending aorto-left axillary bypass.
abstract: BACKGROUND
  Transcatheter application of a stent-graft to the angulated aortic segments with critical side branches poses some problems. We report our technique of distal arch aneurysm repairs using stent-grafts inserted through the aortic arch and ascending aortoaxillary bypass.
  
  
  RESULTS
  Three patients underwent successful distal arch aneurysm repair using a homemade semiflexible stent-graft placed under hypothermic circulatory arrest. The left subclavian artery was reconstructed by an extraanatomic bypass grafting between the ascending aorta and left axillary artery. Postoperative imaging demonstrated reduction of aneurysm size and no endoleaks from an intercostal artery.
  
  
  CONCLUSIONS
  Our technique seems to be useful for repair of distal arch aneurysms and is a less invasive procedure.
authors.affiliation: Second Department of Surgery, Kagoshima University, Faculty of Medicine, Japan. moriyamy@takasaki.hosp.go.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Moriyama
authors.forename: Y
authors.initials: Y
authors.lastname: Iguro
authors.forename: K
authors.initials: K
authors.lastname: Hisatomi
authors.forename: R
authors.initials: R
authors.lastname: Toda
authors.forename: G
authors.initials: G
authors.lastname: Yotsumoto
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed