Toya Naoki, Ohki Takao, Fukushima Soichiro, Shukuzawa Kota, Ito Eisaku, Murakami Yuri, Akiba Tadashi
Division of Vascular Surgery, Department of Surgery, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba, 277-8567, Japan.
Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, 3-18-13 Nishishinbashi, Minato-ku, Tokyo, 105-0003, Japan.
Cardiovasc Intervent Radiol. 2018 Nov;41(11):1648-1653. doi: 10.1007/s00270-018-2058-1. Epub 2018 Aug 17.
The bovine arch is the most common variant of the aortic arch and occurs when the innominate artery shares a common origin with the left common carotid artery. We report an endovascular repair of aortic arch aneurysm in patients with a bovine arch using the Najuta proximal scalloped and fenestrated stent graft.
Thoracic endovascular aneurysm repairs using the Najuta stent graft were performed at our facility. It was inserted and deployed at a zone 0 with precise positional adjustment of the scallop of the stent graft to the brachiocephalic trunk.
Overall, eight patients with bovine aortic arch were treated with fenestrated endovascular aneurysm repair. Technical success was 100% with no 30-day death. The follow-up period ranged from 7 to 29 (median 12) months. None of the patients had a stroke or paraplegia, and no endoleak was observed. All brachiocephalic trunks scalloped, and the left subclavian artery fenestrated vessels remained patent during the follow-up period.
The Najuta stent graft repair of aortic arch aneurysms in patients with a bovine arch is a safe and effective treatment option, with good immediate and short-term results.
牛型主动脉弓是主动脉弓最常见的变异类型，当无名动脉与左颈总动脉共用一个共同起源时出现。我们报告了使用Najuta近端带扇形和开窗的支架型人工血管对牛型主动脉弓患者的主动脉弓动脉瘤进行血管腔内修复。
在我们的机构使用Najuta支架型人工血管进行胸主动脉腔内动脉瘤修复。将其在0区插入并展开，将支架型人工血管的扇形精确调整至头臂干的位置。
总体而言，8例牛型主动脉弓患者接受了开窗血管腔内动脉瘤修复。技术成功率为100%，无30天死亡病例。随访期为7至29（中位数12）个月。所有患者均未发生中风或截瘫，未观察到内漏。在随访期间，所有带扇形的头臂干以及左锁骨下动脉开窗血管均保持通畅。
使用Najuta支架型人工血管修复牛型主动脉弓患者的主动脉弓动脉瘤是一种安全有效的治疗选择，具有良好的即刻和短期效果。
