OBJECTIVETo evaluate the basic procedure of endovascular stent-graft repair in the treatment of aortic arch aneurysm.

METHODS>From March 2000-February 2002, a total of 46 patients with aortic arch aneurysms were treated with the custom-made endovascular stent-graft. Of them, twenty-three patients (50%) had aneurysms at the middle of the arch, 22 patients (48%) had aneurysms at the arch-descending aorta, and 1 patient (2%) had aneurysm at the descending thoracic aorta. The diameter of all stents was 0.15 - 0.25 times larger than that of the aorta proximal to the entry tear of dissection or the opening of aneurysm. The diameter of the proximal end of the stents was ranged from 34 - 38 mm. The length of stents ranged from 90 - 120 mm. The stent was made of shape memory nitinol.

RESULTSThe stent was delivered successfully in 45 patients (98%). None of the patients had any access-related complications. Either the primary entry tear of aortic dissection or the inlet of aneurysm was occluded in 43 patients (96%), with an early endoleak in 2 patients (4%). All truth lumen of the dissection recovered to normal. Of the patients in acute period, 1 was referred to surgical repair and 2 died. Follow-up for 1 month to 23 months, showed late endoleak in 3 patients (7%). Forty-three patients restored normal life.

CONCLUSIONSEndovascular stent-graft could be applied in the repair of aortic arch aneurysm. Further studies are needed to to assess the long-term efficacy of this method.