Objectives：We examined the spring back force （SBF） in the frozen elephant trunk technique between patients receiving a Matsui-Kitamura stent （M group） or a J Graft Open Stent Graft （J group）. Methods：There were 11 cases in the M group and 10 cases in the J group. For all cases, we performed computed tomography（ CT） scan and measured distal arch angle（ DAA） and stent graft angle （SGA）. Results：There was no difference between groups with regards to patient characteristics. The insertion graft length［155±19 mm （M group） versus 138±17 mm （J group）］was significantly longer in the M group（ p＜0.05）. In the J group, the SGA at 1 and 2 years postoperatively（ 105°±18.5° and 114°±19.1°, respectively） were significantly increased compared to that at 1 month postoperatively （99.9°± 18.7°）. In addition, the SGA in the J group was significantly larger than that in the M group during the postoperative period. Conclusions：The SBF in the J group was thought to be significantly larger than that in the M group. SBF was thought to be associated with the stent frame characteristic.

We report a case of marked aneurysmal expansion by type Ⅱ endoleaks 8 years after thoracic endovascular aortic repair. The preoperative chest computed tomography （CT） demonstrated the descending thoracic aorta of 95 mm with type Ⅱ endoleak. We performed suture closure of 3 endoleaks and partial aneurysmorrhaphy via left thoracotomy under partial cardiopulmonary bypass. The postoperative CT showed no endoleak with shrinkage of the aneurysm. The patient was discharged on the 21th postoperative day uneventfully.

We classified 59 patients who underwent thoracic endovascular aortic repair for uncomplicated type B aortic dissection from April 2008 to April 2016 into 3 groups based on time from onset and maximum aortic diameter：SA （2weeks to 1 year since onset；n＝29）, C （＞1 year since onset；n＝17）, and D（maximum aneurysm size≧60 mm；n＝13）. We used the Kaplan-Meier method to analyze survival, major adverse cardiovascular event and the need for additional treatment. There was no significant difference in outcomes between the SA and C groups （p＝0.998） or C and D groups （p＝0.279）, but the results in group D tended to be consistently inferior. The freedom from aneurysm rupture rate was inferior in this group, with a significant difference between groups C and D （p＝0.044）. The time from onset to the procedure and maximum aortic diameter were not significantly associated with the longterm outcomes；however, more aortic ruptures occurred in the group with maximum aortic diameter≧60 mm. Simultaneous treatment for re-entry closure or conventional surgical procedures should be considered for such cases.

Type A acute aortic dissection has a high rate of mortality. Emergent surgical repair is the gold standard treatment, but some patients cannot tolerate the open surgery. Here, we report an 82-year-old patient with a history of cerebral infarction and cerebral bleeding who presented with a depressed level of consciousness and who was in a state of shock. A computed tomography （CT） scan showed cardiac tamponade associated with retrograde type A aortic dissection（RAAD）, with a primary entry tear at a distal site of the left subclavian artery. We therefore performed emergent primary entry closure with stent grafting using the Conformable Gore Tag device and emergent drainage of the cardiac tamponade with subxiphoid pericardiotomy. Postoperative CT scan showed complete closure of the primary entry tear and a completely thrombosed false lumen. Primary entry closure with stent grafting could be an effective option for RAAD that meets anatomical criteria.