Abstract

OBJECTIVES

The open-style stent graft technique has been changing the strategy for true distal arch aneurysms extending to the descending aorta. Our mid-term results of surgical repair using a J-graft open stent graft are presented.

METHODS

Between May 2015 and June 2020, 69 patients with a distal arch aneurysm (53 males, median age 74 years) underwent total arch replacement combined with J-graft open stent deployment. All 59 surviving patients were followed for a median follow-up period of 1.8 (0.6–3.6) years.

RESULTS

Antegrade deployment was successfully performed in all patients without any difficulties. The deployed device was securely fixed at the target area, and it initiated thrombus formation. The diameter of the excluded aneurysm was decreased in 54 patients (91.5%) during the follow-up period. There were no type I endoleaks, but there were 3 type II endoleaks; 2 of the 3 type II endoleaks disappeared during the follow-up period. Additional endovascular operations were performed in 3 patients. There were 10 in-hospital deaths (14.5%), and the incidences of stroke, spinal cord injury and distal embolism were 11.6%, 5.8% and 2.9%, respectively. The 1- and 3-year survival rates were 84.8% and 79.4%, respectively, and the 1- and 3-year freedom from reintervention rates were 97.2% and 81.3%, respectively.

CONCLUSIONS

The J-graft open stent graft was easy to deploy, and it could shift the distal anastomosis to a more proximal side. The mid-term performance of this device was good. It has the potential to provide one-stage repair.

中文翻译：

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使用 J-graft 开放式覆膜支架进行全主动脉弓置换术治疗远端主动脉弓动脉瘤：来自日本两个中心的报告

摘要

目标

开放式覆膜支架技术一直在改变真正远端弓形动脉瘤延伸至降主动脉的策略。我们展示了使用 J 型开放式覆膜支架进行手术修复的中期结果。

方法

2015 年 5 月至 2020 年 6 月，69 名远端弓动脉瘤患者（53 名男性，中位年龄 74 岁）接受了全弓置换联合 J 型移植物开放支架部署。所有 59 名幸存患者的中位随访期为 1.8（0.6-3.6）年。

结果

所有患者均顺利进行了顺行部署，没有任何困难。部署的装置牢固地固定在目标区域，并开始形成血栓。随访期间，54例患者（91.5%）排除的动脉瘤直径减小。无Ⅰ型内漏，Ⅱ型内漏3例；3 例 II 型内漏中有 2 例在随访期间消失。3名患者进行了额外的血管内手术。院内死亡10例（14.5%），中风、脊髓损伤和远端栓塞的发生率分别为11.6%、5.8%和2.9%。1 年和 3 年生存率分别为 84.8% 和 79.4%，1 年和 3 年免于再次干预率分别为 97.2% 和 81.3%。

结论

J-graft 开放式覆膜支架易于展开，并且可以将远端吻合转移到更近端。该设备的中期表现良好。它有可能提供一阶段修复。