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Recently, in Japan, the J Graft Open Stent Graft (JOSG) was commercialized for surgical repair of an aortic aneurysm and aortic dissection and the frozen elephant trunk technique was applied. Kinking of the JOSG is a rare adverse event that requires additional intervention. We experienced 2 patients who developed kinking of a JOSG after translocated total arch replacement with the frozen elephant trunk technique for acute Type A aortic dissection. Both patients had intermittent claudication with a decreased ankle-brachial pressure index after the operation. Computed tomography angiography showed kinking between the non-stent and stent parts of the JOSG. Therefore, we performed endovascular repair. A severely angulated arch preserved by a translocated technique may lead to kinking of a JOSG. This suggests that the removed non-stent part should be as short as possible to prevent kinking of the JOSG.

Kinking of an open stent graft after total arch replacement with the frozen elephant technique for acute Type A aortic dissection