Management of Left Subclavian Artery in Endovascular Stent-Grafting for Distal Aortic Arch Disease
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概要
- 論文の詳細を見る
Background Although the left subclavian artery (LSA) is simply covered to exclude distal aortic arch aneurysm during endovascular stent-grafting, this technique is potentially harmful. Methods and Results Between January 2001 and April 2005, 40 cases of stent-grafting were performed for distal aortic arch diseases. For all 31 elective cases, the LSA occlusion test using a balloon catheter was preoperatively performed to predict critical complications secondary to LSA coverage by a stent graft and this revealed 2 cases in which the LSA was crucial for brain circulation (6.5%). The LSA was saved by using a hand-made fenestrated stent graft without bypass-grafting to the LSA in 22 cases. Bypass-grafting to LSA was performed in 5 cases. The LSA was simply occluded in 13 cases. Hospital mortality rates for the elective and emergency cases were 3.2% and 30.0%, respectively. One elective patient had a cerebral infarction (2.5%). LSA patency was successfully maintained in all 22 cases using a fenestrated stent graft. Conclusion The LSA plays an important role in brain circulation in some patients and so a preoperative LSA occlusion test is helpful when aortic stent-grafting is proposed. Fenestrated stent graft saved the LSA in more than 50% of the present cases.
- 社団法人日本循環器学会の論文
- 2008-02-20
著者
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Hase Mamoru
Department of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine
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Ito Toshiro
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University
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Asai Yasufumi
Department of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine
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Asai Yasufumi
Department Of Traumatology And Critical Care Medicine Sapporo Medical University School Of Medicine
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Asai Yasufumi
Department Of Traumatology And Critical Care Medicine Sapporo Medical University
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Hase Mamoru
Department Of Traumatology And Critical Care Medicine Sapporo Medical University School Of Medicine
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Hase Mamoru
Department Of Traumatology And Critical Care Medicine Sapporo Medical University
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KURIMOTO YOSHIHIKO
Department of Traumatology and Critical Care Medicine, Sapporo Medical University
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Ito Toshiro
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Harada Ryo
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Kuwaki Kenji
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Kawaharada Nobuyoshi
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Morishita Kiyofumi
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Higami Tetsuya
Thoracic and Cardiovascular Surgery, Sapporo Medical University
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Hase Mamoru
Division Of Traumatology And Critical Care Medicine Sapporo Medical University School Of Medicine
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Hase Mamoru
Departments Of Traumatology And Critical Care Medicine Sapporo Medical University
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Kurimoto Yoshihiko
Department Of Traumatology And Clinical Care Medicine Sapporo Medical University
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Harada Ryo
Thoracic And Cardiovascular Surgery Sapporo Medical University
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Kuwaki Kenji
Thoracic And Cardiovascular Surgery Sapporo Medical University
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Asai Yasufumi
Departments Of Traumatology And Critical Care Medicine Sapporo Medical University
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Asai Yasufumi
Department Of Critical Care Medicine Sapporo Medical University School Of Medicine
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Higami Tetsuya
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University
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Hase Mamoru
Department Of Critical Care Medicine Sapporo Medical University School Of Medicine
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Morishita Kiyofumi
Thoracic And Cardiovascular Surgery Sapporo Medical University
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Asai Yasufumi
Division Of Traumatology And Critical Care Medicine Sapporo Medical University School Of Medicine
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Hase Mamoru
Second Department Of Internal Medicine Sapporo Medical University School Of Medicine
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Kawaharada Nobuyoshi
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University
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Morishita Kiyofumi
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University School Of Medicine
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Kurimoto Yoshihiko
Departments Of Traumatology And Critical Care Medicine Sapporo Medical University
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Morishita Kiyofumi
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University Hospital
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Ito Toshiro
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University Of Medicine
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Higami Tetsuya
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University Of Medicine
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