Sato Hiroshi, Fukada Joji, Tamiya Yukihiko, Mikami Takuma, Sibata Tsuyoshi, Harada Ryo, Naraoka Syuichi, Kamada Takeshi, Kawaharada Nobuyoshi, Kurimoto Yoshihiko
Department of Cardiovascular Surgery, Otaru General Hospital, Otaru, Hokkaido, Japan.
Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
Ann Vasc Dis. 2020 Dec 25;13(4):384-389. doi: 10.3400/avd.oa.20-00102.
: The treatment for arch aneurysms by endovascular repair is often difficult. This study evaluated the long-term outcomes of thoracic endovascular aortic repair for aortic arch aneurysms treated with the Najuta stent-graft system. : From January 2009 to December 2019, 37 patients underwent treatment for aortic aneurysms with the Najuta stent graft system at two institutes, including our hospital. We retrospectively analyzed the short- and long-term clinical outcomes. : Of all 37 cases, the technical success rate was 97.3% (36 of 37). The mean proximal neck length was 20.1±5.3 mm. The postoperative results revealed 10 patients with type Ia endoleaks (27.8%), 6 with stroke (16.7%), and one with paraplegia (2.8%). In the chronic phase, the overall survival rates and the rates of freedom from aorta-related events at 7 years were 71.3% and 50.7%, respectively. Between two groups divided based on the proximal neck diameter of 20 mm, the <20-mm group had significantly higher rates of aorta-related events in terms of freedom from aortic events (P=0.046). : The fenestrated stent graft can be a less invasive option for the treatment of high-risk patients with aortic aneurysms.
通过血管腔内修复治疗主动脉弓动脉瘤通常很困难。本研究评估了使用Najuta覆膜支架系统治疗主动脉弓动脉瘤的胸主动脉腔内修复术的长期疗效。
2009年1月至2019年12月,包括我院在内的两家机构对37例患者使用Najuta覆膜支架系统治疗主动脉瘤。我们回顾性分析了短期和长期临床疗效。
在所有37例病例中,技术成功率为97.3%(37例中的36例)。近端锚定区平均长度为20.1±5.3毫米。术后结果显示,10例患者发生I型内漏(27.8%),6例发生卒中(16.7%),1例发生截瘫(2.8%)。在慢性期,7年时的总生存率和无主动脉相关事件发生率分别为71.3%和50.7%。在根据近端锚定区直径20毫米划分的两组之间,<20毫米组在无主动脉事件方面的主动脉相关事件发生率显著更高(P=0.046)。
开窗覆膜支架对于治疗高危主动脉瘤患者可能是一种侵入性较小的选择。