New operative method for acute type B dissection: Left carotid artery–left subclavian artery bypass combined with endovascular stent-graft implantation

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Presentation transcript:

New operative method for acute type B dissection: Left carotid artery–left subclavian artery bypass combined with endovascular stent-graft implantation Norihisa Shigemura, MD, Masaaki Kato, MD, Toru Kuratani, MD, Yasunobu Funakoshi, MD, Mitsunori Kaneko, MD The Journal of Thoracic and Cardiovascular Surgery Volume 120, Issue 2, Pages 406-408 (August 2000) DOI: 10.1067/mtc.2000.107279 Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Preoperative (A and B ) and postoperative (C and D ) aortograms and computed tomograms. A, Preoperative aortogram shows thoracic aortic dissection (T, true lumen; F, false lumen) with an entry site below the left subclavian artery (arrows). B, Preoperative computed tomogram shows an intimal flap in the descending thoracic aorta. C, Postoperative aortogram reveals that the entry was closed by the endovascular stent-graft (large arrow) and that the bypass between the left carotid artery and left subclavian artery was patent (small arrows). D, Postoperative computed tomogram demonstrates complete exclusion of the false lumen through the descending aorta. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 406-408DOI: (10.1067/mtc.2000.107279) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Schema of the new stent-graft implantation method for type B aortic dissection. A, The entry site of type B dissection is located near the origin of the left subclavian artery. B, After the bypass between the left carotid and left subclavian arteries is completed, a 20F catheter sheath is inserted via the femoral artery and the stent-graft is delivered to the intended position by the pushing rod. C, The stent-graft is deployed, extending from the distal arch to the descending aorta, closing the origin of the left subclavian artery and permitting the false lumen to clot. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 406-408DOI: (10.1067/mtc.2000.107279) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions