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Utilizing a long sheath to minimize atheroma manipulation (minimal manipulation approach) during Zone 1 and 2 thoracic endovascular aortic repair with a shaggy aorta

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  • Blood Vessel Prosthesis
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Abstract

We have adopted a simple and reproducible approach, “minimal manipulation approach,” since January 2021 in five patients to minimize the risk of thromboembolic events during Zone 1 and 2 thoracic endovascular aortic repair (TEVARs) with shaggy aorta. The approach consists of two parts: ① Use of a 65-cm-long sheath (dry seal) to deliver the endografts without touching the protruding atheroma. Covering the atheroma with the first endograft delivered at Zone 3 to the mid-descending aorta (paving the aorta), and second endograft insertion and deployment through the paved aorta with first endograft. ② Protection of the left subclavian artery using balloon catheter during TEVAR. No in-hospital mortality was recorded, and none of the patients had stroke, spinal cord ischemia, or distal embolic events.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan

    Hidetake Kawajiri, Takuma Kobayashi, Kaichiro Manabe, Keiichi Kanda & Satoshi Numata

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  1. Hidetake Kawajiri
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  2. Takuma Kobayashi
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  3. Kaichiro Manabe
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  4. Keiichi Kanda
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  5. Satoshi Numata
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Correspondence to Hidetake Kawajiri.

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Kawajiri, H., Kobayashi, T., Manabe, K. et al. Utilizing a long sheath to minimize atheroma manipulation (minimal manipulation approach) during Zone 1 and 2 thoracic endovascular aortic repair with a shaggy aorta. J Artif Organs (2024). https://doi.org/10.1007/s10047-024-01440-4

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  • DOI: https://doi.org/10.1007/s10047-024-01440-4

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