Ann Thorac Surg 1997;63:528
© 1997 The Society of Thoracic Surgeons
Invited Commentary
Invited Commentary
Timothy A. M. Chuter, MD
Department of Surgery, University of California at San Francisco, Department of Veterans Affairs, 4150 Clement St, San Francisco, CA 94121.
See also page 522.
This article describes several potentially important innovations, including reconstruction of the distal aortic arch using a branched stent-graft, use of balloon counterpulsation as a means of stent-graft expansion, and percutaneous insertion of aortic-sized stent-grafts. However, the results do not support the claim that the device is safe and effective. The goal in the endovascular treatment of aortic aneurysm has to be complete exclusion of the affected segment from the circulation, because aneurysms that are still perfused after stent-graft implantation continue to enlarge and sometimes rupture. On the basis of this criterion, success was achieved in only 12 (60%) of the 20 patients. The high rate of perigraft leakage probably reflects the performance of the attachment devices. Simple hoops like these are unable to accommodate any errors in graft sizing; if they are too big, they are not circular, and if they are too small, they exert no outward force. From the standpoint of safety, complications such as paralysis and microembolism cannot be ignored.
Related Article
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Clinical Application of Transluminal Endovascular Graft Placement for Aortic Aneurysms
- Kanji Inoue, Tomoyuki Iwase, Mitsuru Sato, Yuki Yoshida, Terumitsu Tanaka, Yasunobu Kubota, Shunichi Tamaki, Koji Hasegawa, and Ario Yamazato
Ann. Thorac. Surg. 1997 63: 522-528.
[Abstract]
[Full Text]
