Transaortic stent grafting for distal arch aneurysm with antegrade and retrograde extracorporeal circulation.
OBJECTIVE
The purpose of this study was to determine whether cerebrospinal cord injury can be avoided with transaortic stent grafting for distal aortic aneurysm, and whether this technique can be widely used.


METHODS
Seventeen patients underwent distal aortic aneurysm repair with the transaortic stent grafting technique. All patients had a median sternotomy with combined antegrade and retrograde perfusion and selective cerebral perfusion. The stent graft was inserted via an aortotomy at the aortic arch. We evaluated the aneurysms on computed tomography scan 2 weeks and 3 months after surgery.


RESULTS
The follow-up period ranged from 3 to 85 months. There was no operative mortality or cerebrospinal dysfunction. Reoperation was performed in two patients. One patient died 15 days after the second operation. Postoperative computed tomography scan showed early thrombosis of the excluded aneurysmal space in 15 (88.2 %) patients.


CONCLUSIONS
Cerebrospinal cord injury could be avoided by selecting lesions for indications and using a combination of antegrade and retrograde perfusion. This surgical technique is useful for arch aneurysms and can be widely used.
Akiyama
K
K
Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan. kakiyama@med.nihon-u.ac.jp
Nakata
K-I
KI
Kasiwazaki
S
S
Fukushima
S
S
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D001930:Brain Injuries / Q000517:prevention & control; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013119:Spinal Cord Injuries / Q000517:prevention & control; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods*