title: Endovascular aortic repair as second-stage surgery after hybrid open arch repair by the frozen elephant trunk technique for extended thoracic aneurysm.
abstract: OBJECTIVE
  To retrospectively evaluate endovascular aortic repair after hybrid open arch repair using the frozen elephant trunk technique for extended thoracic aneurysm.
  
  
  METHODS
  Thoracic endovascular aortic repair was performed in 10 of 227 patients (4.4%) who had previously undergone treatment by use of the frozen elephant trunk technique. Six patients had extended thoracic aorta, and 4, complicated aortic dissection. Surgery was scheduled at an early stage in 5 patients; the remaining 5 underwent repair for a new lesion that had developed during the chronic period. The interval between 2 stages was 0 to 86 months (mean, 24 months). The distal landing zone was at the level of thoracic vertebra 10 level in 2 patients; 11, in 4; 12, in 2; and lumbar vertebra 1, in 2. All patients underwent preoperative cerebrospinal fluid drainage.
  
  
  RESULTS
  None of the patients died, nor did any have spinal cord injuries. An Endoleak of the stent graft with shrinkage of aneurysm was not observed. The mean follow-up period was 18 months (range, 5-53 months). No deaths or aortic events occurred after the second-stage operation.
  
  
  CONCLUSIONS
  The frozen elephant trunk technique reduced the incidence of second-stage thoracic endovascular aortic repair for extended thoracic aorta and also made the procedure easy and safe.
authors.affiliation: Division of Surgery, Graduate School of Biomedical & Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan. uchidacv@hiroshima-u.ac.jp
authors.forename: Naomichi
authors.initials: N
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kodama
authors.forename: Keijiro
authors.initials: K
authors.lastname: Katayama
authors.forename: Taiichi
authors.initials: T
authors.lastname: Takasaki
authors.forename: Akira
authors.initials: A
authors.lastname: Katayama
authors.forename: Shinya
authors.initials: S
authors.lastname: Takahashi
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome