This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Chu, M. W. A. Articles by DeRose, G. Search for Related Content PubMed PubMed Citation Articles by Chu, M. W. A. Articles by DeRose, G. Social Bookmarking                         What's this?

Endovascular Repair of Thoracic Aortic Disease: Early and Midterm Experience

Division of Cardiac Surgery, University of Western Ontario, London, Ontario, Canada

Thomas L. Forbes, MD

Division of Vascular Surgery, University of Western Ontario, London, Ontario, Canada, tom.forbes{at}lhsc.on.ca

D. Kirk Lawlor, MD

Division of Vascular Surgery, University of Western Ontario, London, Ontario, Canada

Kenneth A. Harris, MD

Division of Vascular Surgery, University of Western Ontario, London, Ontario, Canada

Guy DeRose, MD

Division of Vascular Surgery, University of Western Ontario, London, Ontario, Canada

Thoracic aorta disease remains a challenging problem, and despite improvements, open repair techniques are still associated with significant morbidity and mortality. This is a retrospective review of 53 consecutive patients with thoracic aortic pathology who were treated with endovascular repair between September 1998 and December 2004 at a tertiary-care hospital. Endovascular stent graft placement was performed on 23 elective and 30 emergent patients (34 male patients, mean age 66 years, 21 to 85 years). Completion angiography revealed no endoleak in 47 (89%) patients, a type I endoleak in 4 patients, and a type II endoleak in 2 patients. Operative 30-day mortality for elective aneurysms (n = 22), emergent aneurysms (n = 10), dissection (n = 3), penetrating aortic ulcers (n = 7), and trauma (n = 11) was 0%, 40%, 0%, 29%, and 9%, respectively. In total, 46 (87%) patients survived 30 days, and 36 (78.3%) of the survivors were discharged home free of complications. Two patients (4%) experienced paraplegia. Median follow-up was 22 months (1 to 72 months). Intermediate-term results revealed 41 (89%) patients free of endoleak, stent migration, or aneurysmal expansion. Two (4%) patients required reintervention with an additional stent graft. There were 2 (4%) patients with late aortic-related deaths and four (9%) patients with non—aorticrelated late deaths. Endovascular stent graft placement for thoracic aorta disease can be performed successfully and safely with good perioperative and intermediate-term outcomes. Stent graft complication and reintervention rates are low, whereas intermediate survival rates are good. Long-term efficacy still needs to be evaluated.

Key Words: aneurysm • aortic • aortic dissection • endovascular stent • minimally invasive surgery • trauma

Vascular and Endovascular Surgery, Vol. 41, No. 3, 186-191 (2007)
DOI: 10.1177/1538574406298512


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?