Partial debranching hybrid stent graft for distal aortic arch aneurysms.
OBJECTIVE
To evaluate the early outcomes of treating distal aortic arch aneurysms (DAAAs) with a partial debranching hybrid stent graft, and to analyze the morphology of distances among the supra-aortic branches.


METHODS
We used this stent graft to treat DAAA in 12 patients, by debranching the left common carotid artery (LCCA) and the left subclavian artery (LSA). With computed tomography (CT) data on the collective total 28 thoracic aortic aneurysms, the distances from the LSA to the LCCA and those from the LSA to the brachiocephalic artery (BA) were measured using multiplanar reconstruction (MPR) and centerline of flow (CLF) methods.


RESULTS
All procedures were done in two stages and all stent grafts were deployed in zone-1. The devices used were the TALENT in seven patients and the TAG in five patients. There were no operative deaths, paraplegia, or type-1 or -3 endoleaks. One patient suffered minor cerebral infarction. The distance from the LSA to the BA was longer than that from the LSA to the LCCA by 10 mm in the CLF method and by 13 mm in the MPR method.


CONCLUSIONS
It was possible to achieve a longer proximal landing zone by debranching two supra-aortic branches, the LCCA and the LSA. The partial debranching hybrid stent graft was less invasive and more effective for DAAAs.
Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan. ishibash@aichi-med-u.ac.jp
Hiroyuki
H
Ishibashi
Tsuneo
T
Ishiguchi
Takashi
T
Ohta
Ikuo
I
Sugimoto
Hirohide
H
Iwata
Tetsuya
T
Yamada
Masao
M
Tadakoshi
Noriyuki
N
Hida
Yuki
Y
Orimoto
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D017536:Carotid Artery, Common / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011093:Polyethylene Terephthalates; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D011093:Polyethylene Terephthalates