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Updated: Feb 15, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Kinking of an open stent graft after total arch replacement with the frozen elephant technique for acute Type A
Akimasa Morisaki1, Tadashi Isomura2, Yasuhisa Fukada2
1Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Abstract:
Recently, in Japan, the J Graft Open Stent Graft (JOSG) was commercialized for surgical repair of an aortic aneurysm and aortic dissection and the frozen elephant trunk technique was applied. Kinking of the JOSG is a rare adverse event that requires additional intervention. We experienced 2 patients who developed kinking of a JOSG after translocated total arch replacement with the frozen elephant trunk technique for acute Type A aortic dissection. Both patients had intermittent claudication with a decreased ankle-brachial pressure index after the operation. Computed tomography angiography showed kinking between the non-stent and stent parts of the JOSG. Therefore, we performed endovascular repair. A severely angulated arch preserved by a translocated technique may lead to kinking of a JOSG. This suggests that the removed non-stent part should be as short as possible to prevent kinking of the JOSG.
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