Endovascular repair of the descending thoracic aorta: mid-term results and evaluation of magnetic resonance angiography

J Cardiovasc Surg (Torino). 2007 Feb;48(1):1-6.


Aim: The endoluminal stent-grafting represents an alternative to surgery in the treatment of lesions of the descending thoracic aorta. The purpose of the present study was to evaluate the mid-term results of the Talent stent-graft in the different indications of aortic disease and the use of magnetic resonance angiography (MRA) in the diagnosis of complications.

Methods: Over a 3-year period, 23 patients with a high surgical risk and presenting a localized lesion of the descending thoracic aorta had an implantation of a Talent stent-graft. Indications were degenerative aneurysm (n=13), false aneurysm (n=7) and penetrating atherosclerotic ulcer (n=3). The feasibility of the endovascular treatment and sizing of the aorta and stent-grafts were determined pre-operatively by MRA and intraoperative angiography. Immediate and mid-term technical and clinical success were assessed by clinical and MRA follow-up.

Results: Endovascular treatment was completed successfully in all patients with no conversion to open repair. There was no intraoperative mortality. The mean operative time was 38+/-7 min. Primary success rate was 100%. We didn't have perioperative mortality. The mean follow-up period was 15+/-5 months. The survival rate was 97% (n=22). Regression of the aneurysmal size was observed in 70% (n=16). MRA diagnosed 3 over 4 postoperative endoleaks that were not diagnosed with the CT-scan, and did not interfere with the nitinol structure of the stent-graft.

Conclusions: Endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well selected patients. MRA is well adapted to diagnose postoperative endoleaks.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm, False* / diagnosis
  • Aneurysm, False* / epidemiology
  • Aneurysm, False* / surgery
  • Aorta, Thoracic / pathology
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Thoracic* / diagnosis
  • Aortic Aneurysm, Thoracic* / epidemiology
  • Aortic Aneurysm, Thoracic* / surgery
  • Atherosclerosis* / complications
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / surgery
  • Blood Vessel Prosthesis Implantation / methods*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stents*
  • Survival Rate / trends
  • Time Factors
  • Treatment Outcome
  • Ulcer* / diagnosis
  • Ulcer* / etiology
  • Ulcer* / surgery