| Project/Area Number |
09557111
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 展開研究 |
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| Research Field |
Thoracic surgery
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| Research Institution | Tokyo Medical University |
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Principal Investigator |
ISHMARU Shin Tokyo Medical University Surgery Professor, 医学部, 教授 (50112785)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥6,600,000 (Direct Cost: ¥6,600,000)
Fiscal Year 1998: ¥2,600,000 (Direct Cost: ¥2,600,000)
Fiscal Year 1997: ¥4,000,000 (Direct Cost: ¥4,000,000)
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| Keywords | thoracic aortic aneurysm / spinal cord ischemia / parapleagia / stent graft / endovascular surgery / self-expandable stent / retrievable stent graft |
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| Research Abstract |
Objective: In order to predict spinal cord injury following endovascular stent-graft repair of descending thoracic aortic aneurysms, temporary interruption of the intercostal arteries including the aneurysm was performed by placement of a novel retrievable stent graft (Retriever), in the aorta under evoked spinal cord potential (ESCP) monitoring.
Methods: The Retriever consisted of two units of self-expandable zigzag stents connected in tandem with 9 stainless steel struts. Each strut was collected in a bundle fixed to a pushing rod. The stent framework was lined with an ePTFE sheet. Mechanical function, durability and safety of Retriever were confirmed by a mock circulation with pulsatile flow.
Endovascular stent-graft repair of descending thoracic aortic aneurysms was performed in patients with aneurysm located in the middle and distal segment of the descending aorta after obtaining informed consent. The Retriever was placed temporarily before stent-graft deployment. The Retriever was delivered beyond the aneurysm through a sheath and was retracted into the sheath 21 minutes later. A stent graft for permanent use was deployed in patients with favorable predeployment test results using the Retriever.
Results: The Retriever was placed in 15 patients. There were no changes in amplitude or latency of ESCP records obtained before and during Retriever placement. After withdrawal of the Retriever, all aneurysms were excluded from circulation immediately after permanent stent grafting. There were no changes on ESCP nor neurologic deficits after stent-graft deployment in every patient.
Conclusions: These results suggest that the pre-deployment test using the Retriever under ESCP monitoring is promising as a predictor of spinal cord ischemia in candidates for stent-graft repair of thoracic aortic aneurysms.
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