title: Successful shrinkage of distal arch and proximal descending aortic aneurysm after transaortic endovascular stent-grafting.
abstract: OBJECTIVE
  Although endovascular stent-grafting is available for atherosclerotic thoracic aneurysms, it is unknown whether the excluded thrombosed aneurysms shrink. We evaluated serial changes in distal aortic arch or proximal descending aortic aneurysms excluded space after transaortic stent-grafting.
  
  
  METHODS
  Thirty-four patients with true distal aortic arch or proximal descending thoracic aortic aneurysms were treated by stent-grafts introduced via proximal arch aortic incisions. Follow-up included computed tomographs (CT) every 6 months in 31 patients. The maximum dimensions for excluded space and aneurysmal diameters were measured and evaluated to determine whether the aneurysmal space had decreased or shrunken following this alternative procedure.
  
  
  RESULTS
  Two hospital deaths (5.9%) were caused by a cerebral embolism and a peri-operative myocardial infarction. Another case died from pneumonia a year after surgery. Thirty-one cases (91%) survived during follow-up, but one case suffered from paraplegia (2.9%). The follow-up period ranged from 10 to 72 months (average 39.3+/-27.2 months). There were no aneurysmal ruptures during follow-up. Post-operative serial CTs showed a disappearance or a significant shrinkage of the excluded aneurysmal space in 30 of the 31 cases (97%); one case suffered endoluminal leakage.
  
  
  CONCLUSIONS
  Transaortic endovascular stent-grafting is feasible for distal aortic arch or proximal descending aortic aneurysms. The excluded aneurysmal space disappears or shrinks after successful stent-graft placement.
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. sueda@hiroshima-u.ac.jp
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Orihashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Okada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Imai
authors.forename: Masaki
authors.initials: M
authors.lastname: Hamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome