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J.Jpn. Surg. Soc.. 110(5): 261-265, 2009

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Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

Toru Kuratani

Aortic arch aneurysms are extremely burdensome to treat due to their surgical complexity. In particular, postoperative brain disorders are severe complications that significantly lower patient quality of life (QOL). Surgical treatment has recently changed to minimally invasive procedures to respect patient needs and improve postoperative QOL. As pioneers in arch aneurysm surgery, we have achieved solid results with the open stent grafting technique since 1994 and debranched thoracic endovascular aortic repair since 1997. We also developed a new method of implanting a branched open stent (BOS) graft in the entire distal anastomotic portion, which does not require suturing or lateral thoracotomy. Recently, a clinical trial of the Najuta fenestrated endograft device have been started. Here, we report early and long-term results involving hybrid endovascular repair of aortic arch aneurysms. Our findings suggest that while fenestrated and branched grafts hold promise for treating aortic arch conditions, hybrid endovascular repair may become the first choice for treating aortic aneurysms.

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