Urgent stent-grafting by an original small size stent-graft system for thoracic aortic diseases

Objectives: To obtain an early result of urgent stent-grafting by our original M-K stent-graft system for thoracic aortic diseases.

Methods: From April 1999, 80 patients underwent treatment using our original flexible M-K stent-graft (Fig. 1). Among these patients, 18 patients (23%, 11 males and 7 females; mean age, 56 years old) underwent urgent procedures. Aortic aneurismal rupture was in 10 patients, aortic injury in 7 patients, and aortoenteric fistula in 1 patient. The Straight or curved M-K stents were constructed from a nitinol mono-wire and were covered with very thin-wall woven polyester fabric grafts. The mean stent-graft diameter was 36mm. An 18 or 20F sheath was used as the delivery system.

Fig. 1

Results: In all patients, the stent-grafts were successfully deployed via the femoral artery. Ten patients (56%) were performed under local anesthesia. An axillo-axillary bypass was performed in one patient. Hospital death was observed in 3 patients. No other perioperative complications were observed. Postoperative CT after three months showed complete thrombus formation in all 15 discharged patients (83%) (Fig. 2).

Fig. 2

Conclusion: Eighteen patients with urgent thoracic aortic diseases were treated by our original flexible M-K stent-graft system. Using a small sheath system, straight or curved M-K stent-grafts could be deployed to adequately fit to the aorta as planned. In early results, the survival rate (83%, 15/18 patients) was acceptable. However, careful long-term observation is necessary. Further studies are important for the assessment of such urgent stent-grafting.