ニイナミ　ヒロシ   Niinami Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
言語種別	英語
発表タイトル	Initial Experience of a Precurved Fenestrated/branched Convertible Endograft for Aortic Arch Lesions
会議名	2019 Vascular Annual Meeting
主催者	The Society for Vascular Surgery
学会区分	国際学会及び海外の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎YOKOI Yoshihiko, AZUMA Takashi, NIINAMI Hiroshi
発表年月日	2019/06/12
開催地 （都市, 国名）	Washington, D.C. USA
学会抄録	Journal of Vascular Surgery 69(6),e49-e50 2019
概要	Objectives To evaluate the early Results of an entirely endovascular treatment using a precurved fenestrated/branched convertible endograft for thoracic aortic aneurysms and aortic dissection extended to the aortic arch. Methods From September 2017 to December 2018, 105 patients who required stent graft landing in the aortic arch were treated with precurved fenestrated/branched convertible endograft at 20 Japanese centers. The device has six three-dimensional curved stent skeleton types similar to aortic arch configurations and two to four individual graft fenestrations that are composed of a nitinol ring and hydrogel coils for the availability of additional branch endograft implantations (Fig 1). The endografts were fabricated based on preoperative three-dimensional computed tomographic images. Fenestration sizes were set within each supra-aortic branch diameter (ranged, 7-12 mm) and the branch endografts were implanted as necessary Results Technical and initial success were achieved in 104 and 98 cases, respectively. All of the device's proximal end was at zones 0. The lesions' proximal end ranged from zones 0 to 3 in 9, 32, 58, and 6 patients, and the number of branch endograft implantations was 0 to 4 were 18, 54, 17, 15, and 1, respectively. No branch occlusion or proximal migration of the device occurred and two patients died owing to cerebrovascular complication and access route bleeding. Conclusions A precurved fenestrated/branched convertible endograft for endovascular repair in aortic arch disease minimizes operative complication risks and the physical burden for patients. Although most patients had an inadequate proximal landing zone, low mortality and morbidity and satisfactory clinical success were achieved in early outcomes, suggesting that this entirely endovascular treatment may be effective for aortic arch disease.