title: Utility of Chimney Stentgraft Technique for Patients with Short Zone 1.
abstract: OBJECTIVE
  Arch aneurysm combined with insufficient Zone 1 length remains challenging. While a chimney stentgraft with supra-aortic bypass is a recognized solution for arch aneurysm, no definite strategy has been established yet. The aim of this study was to investigate efficacy of chimney stentgraft for patients with zone 1 of insufficient length.
  
  
  METHODS
  Between 2011 and 2013, 10 consecutive patients with aortic arch aneurysm who were treated with a chimney stentgraft were retrospectively reviewed. The minimum length of zone 1 and length of landing zone inside zone 0 were measured on pre-/post-operative 3D-CT.
  
  
  RESULTS
  Neither in-hospital mortality nor postoperative stroke was encountered. The minimum median length of zone 1 (zone 2 for bovine aortic arch of two patients) on preoperative 3D-CT was 10.1 mm [range: 3.9-15.3]. On postoperative 3D-CT, the median proximal landing length on a major curvature proximal to brachio-cephalic artery was 37.5 [range: 20.9-63.9] mm. Type Ia endoleak was observed in two patients with a landing length along the major curvature of less than 30 mm.
  
  
  CONCLUSIONS
  For patients with insufficient length of zone 1, aneurysm exclusion could be achieved with a chimney stentgraft ensuring sufficient length (>30 mm) of the landing zone inside the ascending aorta along major curvature.
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuda
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sanda
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iba
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Minatoya
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
keywords: aneurysm; aorta; chimney stentgraft technique; insufficient zone 1 length; thoracic endovascular aortic repair