Clinical application of a curved nitinol stent-graft for thoracic aortic aneurysms.
OBJECTIVE
To evaluate the clinical efficacy of a curved nitinol stent-graft for repair of thoracic aortic aneurysms.


METHODS
The Matsui-Kitamura stent-graft (MKSG), composed of a self-expanding nitinol stent and polyester fabric, was shaped to match the aortic curvature of 11 patients (6 men; mean age 72.6 years, range 33-90) with 6 true and 5 false aneurysms of the distal arch or proximal descending aorta. The delivery system was an 18 or 20-F J-shaped sheath combined with a preloader-type introducer. The original mean proximal neck length was 16.4 mm, but 4 patients received an axilloaxillary bypass to lengthen the neck. Although the mean corrected proximal neck length was 21.9 mm (overall), 5 cases still had proximal necks <15 mm long.


RESULTS
All curved MKSGs were successfully deployed in the correct position and fitted to the curvature of the aortic arch, achieving complete aneurysm exclusion in 8 (73%) cases. The other 3 repairs displayed early endoleaks; 1 received an additional MKSG, but the other 2 are being observed. Thirty-day mortality was 0%. One patient developed transient renal failure requiring hemodialysis; no neurological complications were observed.


CONCLUSIONS
Endovascular repair of thoracic aortic aneurysms using curved MKSGs appears to be feasible and clinically effective. A tighter fit of the device to the curvature of the aortic arch may exclude distal arch aneurysms despite a short proximal neck.
Sanada
Junichiro
J
Department of Radiology, Kanazawa University School of Medicine, Japan. sanadaj@rad.m.kanazawa-u.ac.jp
Matsui
Osamu
O
Terayama
Noboru
N
Kobayashi
Satoshi
S
Minami
Tetsuya
T
Kurozumi
Masahiro
M
Ohtake
Hiroshi
H
Urayama
Hiroshi
H
Endo
Masamitsu
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
D000497:Alloys; D011091:Polyesters; C013616:nitinol