Distal embolus protection with an intra-aortic filter during stent-graft repair of a severely atherosclerotic thoracic aortic aneurysm.
PURPOSE: To assess the technical feasibility and efficacy of distal embolus protection with an intra-aortic filter during stent-graft repair in a patient diagnosed with a shaggy aorta. TECHNIQUE: In a 75-year-old man with a severely atherosclerotic thoracic aortic aneurysm, stent-graft repair was combined with transposition of the arch branches to the ascending aorta under thoracotomy. A filtration-type embolus protection device with a nitinol basket and polyester fabric was introduced through a 12-F sheath and opened in the supraceliac aorta during the stent-graft procedure; it was safely pulled back into the sheath after the stent-grafts were implanted. The stent-graft repair was successful, and abundant atheromatous debris was captured in the filter. Neither procedure-related embolic events nor neurological deficits were observed. CONCLUSIONS: Use of the intra-aortic filter device to prevent distal embolism during thoracic stent-graft repairs may be feasible and efficacious in severely atherosclerotic patients.