Related Experiment Video
Updated: Sep 21, 2026
A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Repair of the thoracic aorta by transaortic stent grafting (open stenting)
Naomichi Uchida1, Hiroshi Ishihara, Mitsuru Sakashita
1Department of Cardiovascular Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan. cvgeka@asa-hosp.city.hiroshima.jp
Insights
Direct open stent grafting of the aortic arch shows acceptable early and late results for thoracic arteriosclerotic aneurysms and aortic dissections. Follow-up CT scans can predict outcomes after aortic arch repair.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Late results of direct open stent grafting for aortic arch repair remain largely unreported.
- This study addresses the need for long-term outcome data in aortic arch interventions.
Purpose of the Study:
- To evaluate the early and late outcomes of direct open stent grafting for aortic arch repair.
- To assess the predictive value of follow-up computed tomography (CT) scans in determining late results.
Main Methods:
- A cohort of 47 patients underwent open stent grafting between 1997 and 2000.
- Procedures included carotid artery bypass for thoracic arteriosclerotic aneurysms (TAA) and total aortic arch replacement for Stanford type A acute aortic dissection.
- Stenting with carotid bypass was also performed for Stanford type B chronic aortic dissection.
Main Results:
- Early mortality rates were 11% for TAA, 10% for type A dissection, and 0% for type B dissection.
- Late complications included one TAA patient death from aortic rupture and one type B dissection requiring descending aortic replacement due to stent graft ulceration.
- Follow-up CT scans revealed thrombosis and gradual absorption of aneurysms in TAA patients, thrombosis and dilation in type B dissections, and thrombosis/absorption in type A dissections.
Conclusions:
- Direct open stent grafting of the aortic arch demonstrates acceptable early and late clinical results.
- Follow-up CT imaging is a valuable tool for predicting the long-term outcomes of open stent grafting procedures.
- The technique shows promise for managing complex aortic arch pathologies.
Background:
The late results of direct open stent grafting of the aortic arch for aortic arch repair have not been reported previously.
Methods:
Between September 1997 and December 2000 19 patients underwent open stent grafting with carotid artery bypass for thoracic arteriosclerotic aneurysms (TAA) of the distal aortic arch. In addition, 21 patients underwent open stent grafting with total aortic arch replacement for Stanford type A acute aortic dissection and 7 patients underwent stenting with carotid bypass for Stanford type B chronic aortic dissection.
Results:
The early mortality rate was 11% for TAA, 10% for type A dissection, and 0% for type B dissection. Whereas none of the TAA or type A dissection required a second operation on the thoracic aorta, 1 TAA patient died 6 months postoperatively after sudden aortic rupture and 1 type B patient required descending aortic replacement because of ulceration caused by the stent graft at 11 months postoperatively. On follow-up computed tomography scan, in TAA patients, true aneurysms excluded by the stent graft showed early thrombosis, but the absorption of thrombosed aneurysms started from 1 to 6 months postoperatively and gradually progressed. In patients with type B chronic dissection, the false lumen showed early thrombosis and the true lumen was dilated at the central portion of the graft, which might increase turbulent flow by interaction with the stent. In patients with type A acute dissection, the false lumen showed both early thrombosis and early absorption.
Conclusions:
Early and late results of open stenting are acceptable and follow-up computed tomography scan may be able to predict late results of open stenting.
