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弓部大動脈瘤に対するtotal debranching 胸部ステントグラフト内挿術における術式の変遷―さらなる低侵襲化と脳合併症回避をめざして
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JPY
Abstract
The method of hybrid arch thoracic endovascular aortic repair (TEVAR) to treat aneurysm with zone 0 landing has changed according to its invasiveness and complications. The real chimney technique allows supra-aortic bypass from ascending aorta without side clamp is the current choice of treatment. The comprehensive strategy to prevent stroke during hybrid arch TEVAR consisting of magnetization-prepared rapid acquisition with gradient-echo for evaluation of the atheromatous change and balloon protection of the left subclavian artery has contributed for the marked reduction of stroke. Our current strategy of hybrid arch TEVAR with zone 0 landing is discussed.
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