Endovascular treatment of descending thoracic aortic disease: single-center, 15-year experience.
J Vasc Interv Radiol
; 23(4): 468-75, 2012 Apr.
Article
en En
| MEDLINE
| ID: mdl-22301335
ABSTRACT
PURPOSE:
To report the experience with thoracic endovascular aortic repair (TEVAR) in a single center over a 15-year period. MATERIALS ANDMETHODS:
All patients undergoing TEVAR during the period 1994-2009 were retrospectively evaluated.RESULTS:
The study comprised 133 patients (96 men, age 69.5 years ± 14.7) who underwent 21 emergency and 112 elective TEVAR procedures. Aortic pathologies included 91 aneurysms, 14 pseudoaneurysms, 14 penetrating ulcers with or without pseudoaneurysms or intramural hematomas, 8 type B dissections (3 acute and 5 chronic), and 6 traumatic transections. Technical success was 97.7% with a 30-day mortality of 7.5%. There were 101 patients followed to 1 year, 35 patients followed to 5 years, and 6 patients followed to 10-15 years. The overall estimated survivals at 1 year, 5 years, and 10 years were 81%, 48%, and 36%. The 30-day mortality rates in emergency and elective TEVAR procedures were 23.9% and 4.5% (P = .005). However, among patients who survived > 30 days, there was no significant difference in mortality between groups undergoing emergency and elective TEVAR procedures (P = .9, hazard ratio [HR] 0.94, confidence interval [CI] 0.4-2.2). There was no significant gender survival difference. The 30-day mortality rate in octogenarians (n = 31) was higher than in younger patients (P = .03). Incidences of stroke and paraplegia within 30 days of TEVAR were 6.8% and 2.2%. Endoleaks were found in 39 (29%) patients, and secondary interventions were performed in 6 (4.5%) patients.CONCLUSIONS:
The data support the safety and efficacy of TEVAR for aortic pathologies with a low mortality rate. Younger patients have fewer complications after TEVAR. After the acute perioperative period, TEVAR procedures performed emergently are as durable as the procedures performed electively.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Radiografía Intervencional
/
Aneurisma de la Aorta Torácica
/
Procedimientos Endovasculares
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Vasc Interv Radiol
Asunto de la revista:
ANGIOLOGIA
/
RADIOLOGIA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos