A novel approach to prevent spinal cord ischemia: Inoue stent graft with a side branch of small caliber for the reconstruction of the artery of Adamkiewicz

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Presentation transcript:

A novel approach to prevent spinal cord ischemia: Inoue stent graft with a side branch of small caliber for the reconstruction of the artery of Adamkiewicz Takeshi Shimamoto, MD, Akira Marui, MD, PhD, Yoshimasa Nagata, ME, Mitsuru Sato, ME, Naritatsu Saito, MD, PhD, Takahide Takeda, MD, Makiko Ueda, MD, PhD, Tadashi Ikeda, MD, PhD, Ryuzo Sakata, MD, PhD, Kanji Inoue, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 3, Pages 655-659 (March 2010) DOI: 10.1016/j.jtcvs.2009.05.006 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Inoue stent graft with a side branch of small caliber for implantation into the intercostal artery. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 655-659DOI: (10.1016/j.jtcvs.2009.05.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Schematic representation of the implantation of the branched Inoue stent graft into the canine thoracic aorta and intercostal artery. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 655-659DOI: (10.1016/j.jtcvs.2009.05.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A and B, Schematic representation of LDI, MLD, and lesion length along the side branch of the stent graft. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 655-659DOI: (10.1016/j.jtcvs.2009.05.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Representative angiographic images taken at 1 (A), 4 (B), 8 (C), and 12 (D) weeks after the operation. Note that moderate concentric stenosis appeared at 4 weeks after the operation and did not show any remarkable progression at 8 and 12 weeks after the operation (white arrows). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 655-659DOI: (10.1016/j.jtcvs.2009.05.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, B, and C, Photomicrographs taken at 12 weeks after the implantation of the branched stent graft. Note that the branch portion of the stent graft is patent at 12 weeks after the operation and no thrombus is present. Mild neointimal proliferation can be seen around the stent graft. M, Lumen of the main body of the stent graft; Br, lumen of the branch portion of the stent graft; Strut, stent strut; D, Dacron graft covering the stent graft; Neo, neointimal tissue proliferation. Scale bars: (A) 1 mm, (B) 500 μm, and (C) 200 μm. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 655-659DOI: (10.1016/j.jtcvs.2009.05.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions