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Tailor-Made Tapering Grafts for Large-Neck Aorta.

Takuro Shirasu1,2, Masaru Kimura1, Takanori Kaneko1

  • 1Department of Surgery, Asahi General Hospital, Asahi, Chiba, Japan.

Annals of Vascular Diseases
|April 18, 2022
PubMed
Summary

A novel technique using tailor-made tapering grafts in open abdominal aortic aneurysm surgery addresses challenges posed by large aortic necks. This approach improves outcomes and reduces risks, including kidney injury, in complex cases.

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Area of Science:

  • Vascular Surgery
  • Aortic Aneurysm Repair
  • Surgical Graft Technology

Background:

  • Large aortic necks present significant surgical challenges in abdominal aortic aneurysm (AAA) repair.
  • Standard endovascular and open repair methods may be inadequate, sometimes requiring high-risk paravisceral or thoracoabdominal repair.

Purpose of the Study:

  • To describe and evaluate a technique using tailor-made tapering grafts for open AAA repair in patients with large aortic necks.
  • To assess the efficacy of this technique in managing challenging aortic anatomy and improving patient outcomes.

Main Methods:

  • Development and application of a custom-designed tapering graft for open surgical repair.
  • Surgical technique focused on accommodating large proximal aortic dimensions and minimizing clamping levels.
Keywords:
abdominal aortic aneurysmaortomegalyhostile necklarge neckopen aneurysm repair

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  • Assessment of short-term and midterm outcomes in selected patient cohorts.

    • Main Results:

    • The tailor-made tapering graft effectively addressed discrepancies between the native aorta and the graft in large neck morphology.
    • The technique facilitated lower aortic clamping levels, potentially reducing the incidence of postoperative acute kidney injury.
    • Satisfactory short-term and midterm clinical outcomes were observed in patients undergoing this specialized repair.

    Conclusions:

    • Tailor-made tapering grafts offer a viable and effective solution for open AAA repair in patients with large aortic necks.
    • This technique can mitigate risks associated with challenging anatomy, leading to favorable perioperative and midterm results.