Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, CO, USA; University of Colorado School of Medicine, Aurora, CO, USA.
University of Colorado School of Medicine, Aurora, CO, USA.
Am J Surg. 2022 Oct;224(4):1057-1061. doi: 10.1016/j.amjsurg.2022.07.011. Epub 2022 Jul 21.
The appropriate stent length in frozen elephant trunk replacements (FET) remains debated relative to the risk for paraplegia. However, landing the distal end of the stent beyond the curve of the arch facilitates distal reintervention, which is commonly beyond the 10 cm stent coverage when deployed proximal to the left subclavian artery. The aim of this study was to evaluate outcomes following the use of 15 cm stent grafts in zone 2 (z2, distal to the left common carotid).
Using our single institution-maintained database, 103 zone 2 FET performed from 2016 to 2020 were reviewed.
Of the 103 z2, a 15 cm stent graft was used in 51 operations. The indications for FET included acute and chronic aortic dissection, arch aneurysms, and pseudoaneurysms. The incidence of SCI was 0%. Seven deaths (13.7%) occurred.
The data demonstrates the incidence of post-operative paraplegia to be 0% with 15 cm z2 FET. The understanding of SCI in FET should not only include the stent length but also from where it begins.
在冰冻象鼻替换术（FET）中，支架的适当长度与截瘫风险相关，这一点仍存在争议。然而，支架的远端末端位于弓的曲线之外，便于远端再次介入，而当支架在左锁骨下动脉近端展开时，通常超出 10cm 的支架覆盖范围。本研究的目的是评估在 2 区（z2，左颈总动脉远端）使用 15cm 支架移植物的结果。
使用我们的单机构维护数据库，回顾了 2016 年至 2020 年期间进行的 103 例 z2 FET。
在 103 例 z2 中，51 例使用了 15cm 支架移植物。FET 的适应证包括急性和慢性主动脉夹层、弓部动脉瘤和假性动脉瘤。脊髓损伤的发生率为 0%。7 例死亡（13.7%）。
数据显示，15cm z2 FET 的术后截瘫发生率为 0%。对 FET 中脊髓损伤的理解不仅应包括支架的长度，还应包括支架开始的位置。
