Spanos Konstantinos, Panuccio Giuseppe, Rohlffs Fiona, Heidemann Franziska, Tsilimparis Nikolaos, Kölbel Tilo
German Aortic Center Hamburg, Department of Vascular Medicine, University Heart & Vascular Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
J Endovasc Ther. 2020 Oct;27(5):792-800. doi: 10.1177/1526602820925443. Epub 2020 May 20.
To describe the implantation steps and tips and tricks for the Inner Branch Arch Endograft designed to treat aortic arch aneurysm and chronic type A aortic dissection.
Anatomical suitability criteria should be met in order to use this device. The proximal segment of the graft lands in the ascending aorta distally to the sinotubular junction and the distal segment lands in the descending aorta. The device includes 2 inner branches; the proximal branch is used for a connection to the innominate artery (positioned slightly posterior at 12:30 o'clock), while the second branch is positioned slightly anterior at 11:30 o'clock and is used as a connection to the left common carotid artery. Access, implantation technique, deployment of the device, and catheterization of the branches are described thoroughly.
This Inner Branch Arch Endograft is an appealing alternative to treat aortic arch pathology, especially in patients unsuitable for open repair. Nevertheless, complex aortic arch repair is associated with a learning curve. Meticulous preoperative planning and a high level of concentration intraoperatively are mandatory.
描述用于治疗主动脉弓动脉瘤和慢性A型主动脉夹层的内分支弓部覆膜支架移植物的植入步骤、技巧和窍门。
为使用该装置，应满足解剖学适用性标准。移植物的近端段落在升主动脉内，位于窦管交界处的远侧，远端段落在降主动脉内。该装置包括2个内分支；近端分支用于与无名动脉连接（位于12:30位置稍靠后），而第二个分支位于11:30位置稍靠前，用作与左颈总动脉的连接。详细描述了入路、植入技术、装置的展开以及分支的插管。
这种内分支弓部覆膜支架移植物是治疗主动脉弓病变的一种有吸引力的替代方法，特别是对于不适合开放修复的患者。然而，复杂的主动脉弓修复存在学习曲线。术前精心规划和术中高度专注是必不可少的。
