Endovascular Aortic Repair as Second-Stage Surgery after Hybrid Open Arch Repair by the Frozen Elephant Trunk Technique for Extended Thoracic Aneurysm

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Purpose: To retrospectively evaluate endovascular aortic repair after hybrid open arch repair using the frozen elephant trunk technique for extended thoracic aneurysm.Methods: Thoracic endovascular aortic repair was performed in 10 of 227 patients (4.4%) who had previously undergone treatment by use of the frozen elephant trunk technique. Six patients had extended thoracic aorta, and 4, complicated aortic dissection. Surgery was scheduled at an early stage in 5 patients; the remaining 5 underwent repair for a new lesion that had developed during the chronic period. The interval between 2 stages was 0 to 86 months (mean, 24 months). The distal landing zone was at the level of thoracic vertebra 10 level in 2 patients; 11, in 4; 12, in 2; and lumbar vertebra 1, in 2. All patients underwent preoperative cerebrospinal fluid drainage. Results: None of the patients died, nor did any have spinal cord injuries. An Endoleak of the stent graft with shrinkage of aneurysm was not observed. The mean follow-up period was 18 months (range, 5–53 months). No deaths or aortic events occurred after the second-stage operation. Conclusions: The frozen elephant trunk technique reduced the incidence of second-stage thoracic endovascular aortic repair for extended thoracic aorta and also made the procedure easy and safe.