De-airing an open stent graft to potentially reduce spinal cord injury

  • Susumu IsodaEmail author
  • Ryo Izubuchi
  • Jun Kawashima
  • Ichiya Yamazaki
  • Yoshimi Yano
  • Munetaka Masuda
How to Do It


We have occasionally observed a bubble leaving the suture line of an open stent graft; hence, we hypothesized that de-airing an open stent graft could potentially reduce spinal cord injury. Postoperative computed tomography often showed residual air in thoracic aortic aneurysms, confirmed by the presence of a certain amount of air in an open stent graft in a dry lab. We filled CO2 in the sterilized package of an open stent graft and subsequently filled it with saline, which absorbed the CO2 and entered into the gap of the graft. The clinical benefit of de-airing an open stent graft to reduce the incidence of spinal cord injury needs to be evaluated.


Open stent grafting Spinal cord injury De-air 



We would like to thank Editage ( for English language editing. We would like to thank Mr. Kumazawa Y, Mr. Kajioto R, and Mr. Yokoi N for their medical engineering support. Ethics committee approval for this technique is under investigation.

Compliance with ethical standards

Conflict of interest

Munetaka Masuda received research funding from Japan Lifeline Co. Ltd. Other authors do not have any conflict of interest.

Supplementary material

Supplementary material 1 (MOV 45884 KB)


  1. 1.
    Uchida N. Open stent grafting for complex diseases of the thoracic GTCS aorta: clinical utility. Gen Thorac Cardiovasc Surg. 2013;61(3):118–26.CrossRefGoogle Scholar
  2. 2.
    Ma WG, Zheng J, Sun LZ, Elefteriades JA. Open stented grafts for frozen elephant trunk technique: Technical aspect and current outcomes. Aorta(Stanford). 2015;3(4):122–36.Google Scholar
  3. 3.
    Zipfel B, Buz S, Redlin M, Hullmeine D, Hammerschmidt R, Hetzer R. Spinal cord ischemia after thoracic stent-grafting: causes apart from intercostal artery coverage. Ann Thorac Surg. 2013;96:31–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Miyairi T, Kotsuka Y, Morota T, Kubota H, Shibata K, Ikeda Y, Kitamura T, et al. Paraplegia after open surgery using endovascular stent graft for aortic arch repair. J Thorac Cardiovasc Surg. 2001;122:1240–3.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryFujisawa City HospitalFujisawaJapan
  2. 2.Yano Heart ClinicFujisawaJapan
  3. 3.Department of SurgeryYokohama City UniversityYokohamaJapan

Personalised recommendations