Short-Term Results of Thoracic Endovascular Aortic Repair for Aortic Arch Aneurysm with a Fenestrated Stent Graft

The purpose of this study was to review short-term results of aortic arch aneurysm treatment that were performed with fenestrated stent grafts (Najuta stent grafts) in our hospital. Nine patients of aortic arch aneurysm were treated with Najuta stent grafts between January 2015 and March 2018. Eight patients had a saccular aneurysm and one a dissecting aneurysm. A Najuta stent graft was deployed in the aortic arch in each patient. If necessary, a non-fenestrated stent graft was added, and bilateral axillary artery bypass or left subclavian artery embolisation was performed. Computed tomography (CT) examination was performed postoperatively, at 6 months, and yearly. In all patients, the stent grafts were deployed as planned. The blood flow of the brachiocephalic artery and left common carotid artery was maintained through fenestrations of the stent graft. Eight patients required occlusion of the left subclavian artery to get a sufficient proximal sealing zone; five of them were reconstructed. All patients were treated with fewer branch reconstructions than would have been required with conventional stent grafts. In one patient, a lower limb embolism occurred during the operation. On postoperative CT, endoleaks were observed in three patients. Coil embolisation of the left subclavian artery was performed within a year for two patients. The clinical course was evaluated for up to 4 years. Aneurysms shrank slightly in five patients, remained unchanged in three patients, and expanded in one patient. Najuta stent grafts performed well and enabled treatment of aortic arch aneurysms with minimal aortic branch reconstruction.