Endovascular repair of localized pathological lesions of the descending thoracic aorta: midterm results

Cardiovasc Intervent Radiol. Jul-Aug 2007;30(4):628-37. doi: 10.1007/s00270-007-9030-9.

Abstract

The endoluminal stent-graft represents an attractive and a less invasive technique for treatment of various diseases of the descending thoracic aorta. The purpose of this study was to evaluate the Talent endovascular stent-graft for the treatment of various localized diseases of the descending thoracic aorta. Over a 3-year period, Talent thoracic endografts were placed in 40 patients with a high surgical risk, presenting a localized lesion of the descending thoracic aorta: degenerative aneurysm (n = 13), acute traumatic rupture (n = 11), acute Stanford type B aortic dissection (n = 6), false aneurysm (n = 7), and penetrating atherosclerotic ulcer (n = 3). Fifteen patients (37.5%) were treated as emergencies. The feasibility of endovascular treatment and sizing of the aorta and stent-grafts were determined preoperatively by magnetic resonance angiography (MRA) and intraoperative angiography. Immediate and mid-term technical and clinical success was assessed by clinical and MRA follow-up. Endovascular treatment was completed successfully in all 40 patients, with no conversion to open repair or intraoperative mortality. The mean operative time was 37.5 +/- 7 min. The overall 30-day mortality rate was 10% (n = 4), all in emergency cases, for causes not related to the endograft. The primary technical success was 92.5%. The mean follow-up period was 15 +/- 5 months. The survival rate was 95% (n = 35). Diminution of the aneurismal size was observed in 47.5% (n = 19). We conclude that 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.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Dissecting / diagnosis
  • Aneurysm, Dissecting / surgery
  • Aneurysm, False / diagnosis
  • Aneurysm, False / surgery
  • Angioplasty*
  • Aorta, Thoracic / injuries
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / surgery
  • Aortic Diseases / diagnosis
  • Aortic Diseases / surgery*
  • Aortic Rupture / diagnosis
  • Aortic Rupture / surgery
  • Aortography
  • Atherosclerosis / diagnosis
  • Atherosclerosis / surgery
  • Blood Vessel Prosthesis*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prosthesis Design
  • Stents*
  • Ulcer / diagnosis
  • Ulcer / surgery
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / surgery