Stent grafting technique using Matsui-Kitamura (MK) stent for patients with aortic arch aneurysm

Junetsu Akasaka, Koichi Tabayashi, Yoshikatsu Saiki, Katsuhiko Oda, Kiichiro Kumagai, Atsushi Iguchi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Objective: Although several methods of stent-grafting for patients with aortic arch aneurysm have been reported, these methods have been associated with several complications such as endoleak and migration. We developed a new method using Matsui-Kitamura (MK) stent-graft following extra-anatomic arch vessels bypass by selective cerebral perfusion (SCP) under left heart bypass (LHB). Methods: Between December 2001 and December 2003, 12 patients with aortic arch aneurysm were treated according to this new method. All patients were male with an average age of 71.3 ± 6.4 years. There were 5 patients with severe pulmonary dysfunction, 4 with renal dysfunction, one with severe cardiac dysfunction and 3 with preoperative cerebral infarction. Under SCP using LHB, the extra-anatomic arch vessel bypass was established. The MK stent-graft was delivered into the aortic arch. Coronary artery bypass grafting (CABG) was concomitantly performed in one patient. Results: There were no cases of endoleak, migration or hospital death. One patient, who had a past history of cerebrovascular disease, suffered a minor stroke, and one patient, who was performed CABG to the mid-left anterior descending branch (LAD) using the left internal thoracic artery (LITA), presented paraparesis. Although two patients of chronic renal failure underwent scheduled CHDF on account of using the contrast medium during the procedure, all of them were weaned from hemodialysis. However, there were no other postoperative complications such as, respiratory failure or cardiac dysfunction. Conclusions: Endovascular stent grafting EVSG using the MK stent with extra-anatomic arch vessel bypass under SCP using LHB could be a useful and less invasive method for patients with aortic arch aneurysm who are at a high surgical risk.

Original languageEnglish
Pages (from-to)649-653
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume27
Issue number4
DOIs
Publication statusPublished - 2005 Apr

Keywords

  • Aortic arch aneurysm
  • Extra-anatomical bypass
  • Left heart bypass
  • Selective cerebral perfusion
  • Stent-graft

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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