Inoue Y, Matsuda H, Fukuda T, Sanda Y, Morita Y, Oda T, Iba Y, Tanaka H, Sasaki H, Minatoya K, Kobayashi J. Utility of Chimney Stentgraft Technique for Patients with Short Zone 1.
Ann Vasc Dis 2015;
8:302-6. [PMID:
26730255 DOI:
10.3400/avd.oa.15-00043]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/08/2015] [Indexed: 11/13/2022] Open
Abstract
PURPOSE
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.
CONCLUSION
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.
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