title: Usefulness of fenestrated stent grafts for thoracic aortic aneurysms.
abstract: OBJECTIVE
  Endovascular stent grafts (SGs) comprise a novel therapeutic approach to repairing aortic aneurysms. However, endovascular repair of the aortic arch remains challenging. Generally, the repair of sites with SGs requires an extra-anatomical bypass. We introduced SG repair of the aortic arch with strategically positioned fenestrations for each arch branch in 2006. An extra-anatomical bypass is not required for this procedure. This study evaluates the early and mid-term outcomes of fenestrated SG treatment.
  
  
  METHODS
  We retrospectively analysed the early and mid-term outcomes of 24 of 80 repairs with fenestrated SG among 383 single thoracic aortic aneurysm repairs that were undertaken at our department between January 2006 and March 2012.
  
  
  RESULTS
  Technical success was obtained in 100% of the patients. However, there was a 30-day perioperative mortality rate of 4.1% (1 of 24) due to a shower embolism. One patient developed a Type 2 endoleak without aneurysm enlargement within a median follow-up time is 25.1 months. However, migrations or device-related complications requiring additional procedures did not arise.
  
  
  CONCLUSIONS
  Treatment with fenestrated SGs does not require surgical transposition of the arch branches. The procedure is widely applicable and less invasive and outcomes are excellent.
authors.affiliation: Department of Cardiovascular Surgery, Saitama Medical Center of Jichi Medical University, Saitama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yuri
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yokoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Daijiro
authors.initials: D
authors.lastname: Hori
authors.forename: Koichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Hideo
authors.initials: H
authors.lastname: Adachi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
keywords: Endovascular repair; Fenestrated stent graft; Thoracic aortic aneurysm