Uchida Naomichi, Kodama Hiroshi, Katayama Keijiro, Takasaki Taiichi, Katayama Akira, Takahashi Shinya, Sueda Taijiro
Division of Surgery, Graduate School of Biomedical & Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.
Ann Thorac Cardiovasc Surg. 2013;19(3):257-61. doi: 10.5761/atcs.nm.12.01918. Epub 2012 Aug 20.
To retrospectively evaluate endovascular aortic repair after hybrid open arch repair using the frozen elephant trunk technique for extended thoracic aneurysm.
Thoracic endovascular aortic repair was performed in 10 of 227 patients (4.4%) who had previously undergone treatment by use of the frozen elephant trunk technique. Six patients had extended thoracic aorta, and 4, complicated aortic dissection. Surgery was scheduled at an early stage in 5 patients; the remaining 5 underwent repair for a new lesion that had developed during the chronic period. The interval between 2 stages was 0 to 86 months (mean, 24 months). The distal landing zone was at the level of thoracic vertebra 10 level in 2 patients; 11, in 4; 12, in 2; and lumbar vertebra 1, in 2. All patients underwent preoperative cerebrospinal fluid drainage.
None of the patients died, nor did any have spinal cord injuries. An Endoleak of the stent graft with shrinkage of aneurysm was not observed. The mean follow-up period was 18 months (range, 5-53 months). No deaths or aortic events occurred after the second-stage operation.
The frozen elephant trunk technique reduced the incidence of second-stage thoracic endovascular aortic repair for extended thoracic aorta and also made the procedure easy and safe.
回顾性评估采用冰冻象鼻技术行杂交开放性主动脉弓修复术后进行胸主动脉腔内修复治疗累及胸段的动脉瘤的效果。
227例患者中10例（4.4%）此前接受过冰冻象鼻技术治疗，随后接受了胸主动脉腔内修复术。6例患者为累及胸段的主动脉病变，4例为复杂性主动脉夹层。5例患者在早期安排了手术；其余5例针对慢性期出现的新病变进行修复。两期手术间隔为0至86个月（平均24个月）。2例患者的远端锚定区位于胸10水平；4例位于胸11；2例位于胸12；2例位于腰1。所有患者术前均行脑脊液引流。
患者均未死亡，也无脊髓损伤发生。未观察到支架移植物内漏伴动脉瘤缩小的情况。平均随访期为18个月（范围5至53个月）。二期手术后无死亡或主动脉相关事件发生。
冰冻象鼻技术降低了二期胸主动脉腔内修复治疗累及胸段主动脉病变的发生率，且使手术操作简便、安全。
