Stent graft treatment of thoracic aortic disease.
Surg Technol Int
; 12: 189-93, 2004.
Article
de En
| MEDLINE
| ID: mdl-15455325
ABSTRACT
This study was a retrospective analysis of both the efficacy and long-term outcome of endovascular management of thoracic aortic disease. From March 1999 to August 2003, 129 patients (110 males; 19 females) were enrolled. They were divided into four groups aneurysms (41, 5 of which acutely ruptured, Group A), post-traumatic lesions (24, 14 acute and 10 chronic, Group B) and complicated type B dissections (42, 23 acute and 19 chronic, Group C). Twenty-two of the 129 patients with chronic type B dissection, not suitable for endovascular treatment, received medical management only (Group D). All patients underwent computed tomography (CT) scan and angiography as preoperative assessment. Stent-graft systems were Talent -Medtronic, Excluder-Gore, Zenith-Cook and Endofit-Endomed, deployed by transesophageal echocardiography (TEE) monitoring. An optimal deployment with sealing of the graft was achieved in 95.3% (102/107) of the treated patients discharged in good condition within 6 days. Five patients (3 in Group A and 2 in Group C) underwent endovascular completion of the elephant trunk technique successfully. In 5 patients affected by atherosclerotic aneurysm, in a single-time procedure, we have also treated the abdominal aortic aneurysm by endovascular. No spinal cord injuries were observed. The follow up (average 20.82+/-10.01 months), performed with serial chest CT scans, was 100% complete. No stent-graft related complications were detected. In 2 patients with chronic dissection, an asymptomatic type II endoleak was detected. A total of 4 hospital deaths resulted in an overall operative mortality rate of 3.7%. Seven patients (6.5%) died during the follow-up period, whereas a 31.8% (7/22) mortality rate (p<0.001) was observed within the medical treatment group. Endovascular treatment of thoracic aortic diseases, even in the acute phase, may represent a valid option, especially when compared to medical therapy.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Endoprothèses
/
Anévrysme de l'aorte thoracique
/
Implantation de prothèses vasculaires
Type d'étude:
Diagnostic_studies
/
Observational_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Surg Technol Int
Année:
2004
Type de document:
Article
Pays d'affiliation:
Italie