[Reconstruction of neck vessels in endovascular repair of aortic arch aneurysms].
We report 6 cases of aortic arch aneurysms necessitating reconstruction of the neck vessel during stent-graft (SG) placement. All patients were male and their average age was 75 years. The proximal landing zone was zone 0 in 2, zone 1 in 2, and zone 2 in 2 patients. The left subclavian artery (LSCA) was revascularized in every case; using left common carotid artery (LCCA)-LSCA bypass in 3, axillo-axillary artery bypass in 2, and LSCA transposition in 1. Prophylactic LCCA revascularization was done in 2 in which obstruction of LCCA by SG was anticipated. The proximal portion of LSCA from the origin of the vertebral artery was ligated in 3, and divided in 1. Two types of SG were used; Z stent in 1 and Matsui-Kitamura stent in 5. There was no hospital death or perioperative stroke. In the patient with Z stent, SG could not be deployed because of kinking of the delivery system. This patient subsequently underwent surgical SG placement under hypothermic circulatory arrest. In the other 5, SG was deployed without any type of endoleak. Postoperative complication included incomplete phrenic nerve palsy in 1. Prophylactic bypass for LCCA was divided because SG did not obstruct the antegrade flow of LCCA. Revascularization of neck vessels can be performed with low morbidity in endovascular repair of aortic arch aneurysms.
Matsuzaki
Kenji
K
Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Shiiya
N
N
Kunihara
T
T
Murashita
T
T
Matsui
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery*; D014656:Vascular Surgical Procedures