Yunoki Junji, Kuratani Toru, Shirakawa Yukitoshi, Torikai Kei, Shimamura Kazuo, Kin Keiwa, Sawa Yoshiki
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan,
Gen Thorac Cardiovasc Surg. 2015 Jan;63(1):38-42. doi: 10.1007/s11748-014-0436-4. Epub 2014 Jun 17.
To confirm the validity of using Gore TAG for degenerative descending thoracic aneurysm repair, we evaluated the mid-term clinical outcomes in our single-center experience.
From May 2008 to April 2011, elective thoracic endovascular aortic repair (TEVAR) with Gore TAG without left subclavian artery (LSA) coverage for a degenerative descending thoracic aneurysm was performed in 36 consecutive cases.
The procedural success rate was 100%, and no patient died within 30 days of the operation. We observed no cases of paraplegia or stroke. The mean follow-up was 33.2 ± 13.0 months (the maximum follow-up was 58.0 months). The actuarial survival rate was 100, 97.2 and 94.4% at 1, 2 and 3 years. There was no aorta-related death at 3 years. Two (5.6%) late distal Type I endoleaks were observed. Freedom form aortic events rate was 97.2, 97.2, and 97.2% at 1, 2, and 3 years respectively. In six cases with bird-beak configurations at the 2-year follow-up, the bird-beak length and angle had increased gradually.
Elective TEVAR using the Gore TAG for degenerative descending thoracic aortic aneurysms without LSA coverage is effective and provides satisfactory early and mid-term outcomes. However, since the bird-beak configurations progressed, a conformable and flexible device for the next generation of procedures will be needed.
为证实使用戈尔TAG（Gore TAG）修复退行性降主动脉瘤的有效性，我们评估了单中心经验中的中期临床结果。
2008年5月至2011年4月，连续36例患者接受了使用戈尔TAG且未覆盖左锁骨下动脉（LSA）的选择性胸主动脉腔内修复术（TEVAR）治疗退行性降主动脉瘤。
手术成功率为100%，术后30天内无患者死亡。未观察到截瘫或中风病例。平均随访时间为33.2±13.0个月（最长随访时间为58.0个月）。1年、2年和3年的精算生存率分别为100%、97.2%和94.4%。3年时无主动脉相关死亡。观察到2例（5.6%）晚期远端I型内漏。1年、2年和3年时无主动脉事件发生率分别为97.2%、97.2%和97.2%。在2年随访时有6例呈鸟嘴样形态，鸟嘴长度和角度逐渐增加。
使用戈尔TAG对退行性降主动脉瘤进行选择性TEVAR且不覆盖LSA是有效的，并能提供满意的早期和中期结果。然而，由于鸟嘴样形态进展，未来需要一种顺应性和灵活性更好的器械用于手术。
