Distal embolus protection with an intra-aortic filter during stent-graft repair of a severely atherosclerotic thoracic aortic aneurysm.
OBJECTIVE
To assess the technical feasibility and efficacy of distal embolus protection with an intra-aortic filter during stent-graft repair in a patient diagnosed with a shaggy aorta.


METHODS
In a 75-year-old man with a severely atherosclerotic thoracic aortic aneurysm, stent-graft repair was combined with transposition of the arch branches to the ascending aorta under thoracotomy. A filtration-type embolus protection device with a nitinol basket and polyester fabric was introduced through a 12-F sheath and opened in the supraceliac aorta during the stent-graft procedure; it was safely pulled back into the sheath after the stent-grafts were implanted. The stent-graft repair was successful, and abundant atheromatous debris was captured in the filter. Neither procedure-related embolic events nor neurological deficits were observed.


CONCLUSIONS
Use of the intra-aortic filter device to prevent distal embolism during thoracic stent-graft repairs may be feasible and efficacious in severely atherosclerotic patients.
Sanada
Junichiro
J
Department of Radiology, Kanazawa University Hospital, Japan. sanadaj@rad.m.kanazawa-u.ac.jp
Matsui
Osamu
O
Ohtake
Hiroshi
H
Kimura
Keiichi
K
Kusanagi
Miho
M
Terayama
Noboru
N
D000368:Aged; D000497:Alloys; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003287:Contrast Media; D004617:Embolism / Q000517:prevention & control*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000497:Alloys; D003287:Contrast Media; C013616:nitinol