Profiles

Affiliation

• Department of Cardiovascular Surgery, Associate Professor

Research achievements

Published Papers

Case report
• Two Cases of Intrathoracic Subclavian Artery Aneurysm Treated with Endovascular Treatment Combinations, Masahito Saito, Kei Torikai, Kazuho Niimi, Naoki Asano, Ryohei Tsuji, Hironaga Ogawa, Hiroshi Takano, Dokkyo Medical Journal, 05 Jul. 2023

  DOI

Presentations

• TEVAR with total isolation procedure using ECMO for shaggy aorta cases, 21 Nov. 2025, 20 Nov. 2025, 22 Nov. 2025, Oral presentation, Japan, 【Background】TEVAR in patients with shaggy aorta carries high risk of cerebral infarction. We report two cases where cerebral infarction was successfully prevented using a total isolation procedure with ECMO support. 【Cases】Two patients were considered high-risk for open surgical repair due to frailty and comorbidities. Case 1: A 78-year-old male with Alzheimer's dementia and enlarging aortic arch saccular aneurysm underwent TEVAR using Najuta® stent graft. ECMO inflow was established through a 9mm graft sutured to the right axillary artery, creating retrograde flow in the brachiocephalic artery for cerebral protection. The left common carotid artery was manually compressed, and the left subclavian artery was balloon-occluded. The patient was discharged ambulatory on postoperative day 18 without neurological complications. Case 2: An 85-year-old male with 62mm thoracic aortic aneurysm underwent 2 debranching TEVAR with ECMO support. A T-shaped graft from the right axillary artery bypassed the left axillary and left common carotid arteries. ECMO inflow was established through an 8mm graft near the right axillary anastomosis, with retrograde BCA flow providing cerebral protection. Despite developing incomplete paraplegia, no cerebral infarction occurred, and the patient was transferred to rehabilitation on postoperative day 20. 【Conclusion】ECMO-assisted total isolation procedure effectively prevents cerebral embolization during TEVAR for shaggy aorta by maintaining cerebral perfusion through retrograde brachiocephalic flow while isolating other arch branches. This technique represents a valuable therapeutic approach for high-risk patients, demonstrating reliable cerebral protection in both cases without stroke complications., False