He Huang1, Yuanyong Jiao2, Yepeng Zhang1, Yuelin Zhu1, Zhao Liu1, Tong Qiao1, Changjian Liu1, Xiwei Zhang3, Min Zhou4. 1. Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China. 2. Department of Vascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China. 3. Department of Vascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China. xiweinanjing@163.com. 4. Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China. zhouminnju@gmail.com.
Abstract
OBJECTIVE: To report the early results of castor device, a kind of unibody single-branched stent graft, in the treatment of type B aortic dissection (TBAD) involving the LSA. METHODS: From April 2013 to February 2014, 21 patients with TBADs underwent TEVAR with LSA revascularization by unibody single-branched stent grafts. Three patients with penetrating aortic ulcers in the aortic arch received additional reconstruction of left common carotid artery with chimney technique. Follow-up evaluations were conducted with computed tomography angiography (CTA) at 6, 12 months and annually after that. RESULTS: All of the proximal entry tears were completely excluded. Good patency of the grafts was found in all cases. A small type I endoleak occurred in one patient during the procedure. Perioperative mortality is null, and there was no occurrence of serious complications. All patients completed the follow-up except one lost contact after discharge. One death occurred within 6 months after the operation, resulting from myocardial infarction, considered unrelated to the stent implantation. No endoleak occurred during follow-up. One compression of a chimney stent and one twist of side branch graft of castor were observed in 2 different patients, respectively. In other cases, CTA scans showed good patency of both the branched and chimney grafts. Two patients had partial thrombosis of the false lumen during follow-up. In other patients, complete thrombosis in the false lumen in thoracic aorta was revealed. CONCLUSION: The single-branched stent graft was safe and efficient in the 1-year follow-up. Further studies are required to determine its long-term outcomes.
OBJECTIVE: To report the early results of castor device, a kind of unibody single-branched stent graft, in the treatment of type B aortic dissection (TBAD) involving the LSA. METHODS: From April 2013 to February 2014, 21 patients with TBADs underwent TEVAR with LSA revascularization by unibody single-branched stent grafts. Three patients with penetrating aortic ulcers in the aortic arch received additional reconstruction of left common carotid artery with chimney technique. Follow-up evaluations were conducted with computed tomography angiography (CTA) at 6, 12 months and annually after that. RESULTS: All of the proximal entry tears were completely excluded. Good patency of the grafts was found in all cases. A small type I endoleak occurred in one patient during the procedure. Perioperative mortality is null, and there was no occurrence of serious complications. All patients completed the follow-up except one lost contact after discharge. One death occurred within 6 months after the operation, resulting from myocardial infarction, considered unrelated to the stent implantation. No endoleak occurred during follow-up. One compression of a chimney stent and one twist of side branch graft of castor were observed in 2 different patients, respectively. In other cases, CTA scans showed good patency of both the branched and chimney grafts. Two patients had partial thrombosis of the false lumen during follow-up. In other patients, complete thrombosis in the false lumen in thoracic aorta was revealed. CONCLUSION: The single-branched stent graft was safe and efficient in the 1-year follow-up. Further studies are required to determine its long-term outcomes.
Authors: Theodorus M van Bakel; Hector W de Beaufort; Santi Trimarchi; Massimiliano M Marrocco-Trischitta; Jean Bismuth; Frans L Moll; Himanshu J Patel; Joost A van Herwaarden Journal: Ann Cardiothorac Surg Date: 2018-05
Authors: Alexander A Brescia; Himanshu J Patel; Donald S Likosky; Tessa M F Watt; Xiaoting Wu; Raymond J Strobel; Karen M Kim; Shinichi Fukuhara; Bo Yang; G Michael Deeb; Michael P Thompson Journal: Ann Thorac Surg Date: 2019-08-07 Impact factor: 4.330