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General Thoracic and Cardiovascular Surgery

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Open Access 01-03-2013 | Current Topics Review Article

Open stent grafting for complex diseases of the thoracic aorta: clinical utility

Author: Naomichi Uchida

Published in: General Thoracic and Cardiovascular Surgery | Issue 3/2013

Abstract

Open stent grafting is an alternative treatment for extensive thoracic aortic replacement. However, this procedure is associated with a high incidence of spinal cord injury, which has limited its application. Multiple factors have been suggested to explain the risk of spinal cord injury, including deep delivery of the stent graft, history of operation of the downstream aorta, and postoperative low blood pressure. Cerebrospinal fluid drainage or a hybrid operation in combination with trans-femoral thoracic stent grafting is useful for preventing spinal cord injury. Open stent grafting remains an alternative treatment for atherosclerotic aneurysms with dilatation of the ascending aorta. Open stent grafting for acute aortic dissection is effective for remodeling of the false lumen. The graft diameter for aortic dissection should be 90 % of the total diameter of the aorta, and the distal landing zone should be limited to the T7 vertebral level to prevent new intimal tears or spinal cord injury. Open stent grafting seems a feasible bailout strategy for the treatment of retrograde aortic dissection after TEVAR for type B aortic dissection. Newly designed devices for open stent grafts include the Matsui-Kitamura stent graft or branched open stent graft, which is produced in Japan. The effectiveness of open stent grafting in the treatment of Marfan syndrome remains unclear. A commercially available device for open stent grafting would be desired in Japan. In conclusion, an open stent graft remains an alternative treatment for complex thoracic aortic pathologies.

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Title: Open stent grafting for complex diseases of the thoracic aorta: clinical utility
Author: Naomichi Uchida
Publication date: 01-03-2013
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 3/2013
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-012-0151-y

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Springer Medicine

Open stent grafting for complex diseases of the thoracic aorta: clinical utility

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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