Stent-grafting of the thoracic aorta: feasibility and early results in acute and chronic lesions.

Abstract

BACKGROUND AND AIMS:

Conventional surgery of the thoracic aorta is frequently associated with significant mortality and morbidity. Here we present treatment of surgical pathologies of the thoracic aorta using a less invasive endovascular approach.

METHODS:

From January 2000 to May 2004, 51 patients (mean age 62.7 +/- 12.8 years, 36 men) underwent endovascular repair of thoracic aortic lesions in our institution. All patients underwent computed tomography scan at discharge, 6 and 12 months and annually thereafter. Clinical follow-up was carried out by outpatient clinic visit or by telephone contact with the patients or their referring physicians. Mean follow-up was 15.8 months.

RESULTS:

The 30-day mortality rate was 3.8%, one death in the group of chronic (1.9%) and one in the group of acute lesion (1.9%). The survival rate in the follow-up period was 92.4% at 6 months. Computed tomography angiography confirmed exclusion of the lesion in 25 out of 27 chronic patients, whereas type I and II endoleaks were detected in two patients treated with a secondary procedure. In addition, two patients with an acute type B aortic dissection presented with early endoleaks. The overall rate of complications was 10%. No other endoleaks or deaths were observed at later follow-up.

CONCLUSIONS:

The early and mid-term results of endovascular stent-grafting for the treatment of chronic and acute thoracic aortic diseases showed a good outcome and low rate of complications. Stent-grafting of the thoracic aorta is still an investigational procedure that needs further validation.

• Authors: Ugolino Livi, Gianluca Piccoli, Giovanni Ciccarese, Igor Vendramin, Romeo Frassani, Alessandro Vit, Massimo Sponza, Andrea Marzio, Nevio Gonano, Daniele Gasparini
• Journal: Journal of cardiovascular medicine (Hagerstown, Md.) (J Cardiovasc Med (Hagerstown)) Vol. 8 Issue 7 Pg. 504-10 (Jul 2007) ISSN: 1558-2027 [Print] United States
• PMID: 17568283 (Publication Type: Journal Article)

Topics

• Acute Disease
• Adult
• Aged
• Aortic Dissection (pathology, surgery)
• Aorta, Thoracic (injuries, pathology, surgery)
• Aortic Diseases (mortality, pathology, surgery)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (adverse effects)
• Chronic Disease
• Coronary Artery Disease (complications)
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Radiography, Interventional
• Stents
• Treatment Outcome
• Ulcer (etiology, pathology, surgery)
• Ultrasonography, Interventional