Stenting of the descending thoracic aorta: a six-year single-center experience (Journal article)
Matsagkas, M. I./ Kirou, I. E./ Kouvelos, G./ Arnaoutoglou, E. M./ Papakostas, J. C./ Katsouras, C./ Papadopoulos, G./ Michalis, L. K.
OBJECTIVES: The aim of this study was to review the six-year results of the endovascular repair of descending thoracic aortic pathologies, reporting the early perioperative outcomes as well as the mid-term follow-up of the treated patients. METHODS: Fifty-five consecutive patients who underwent endovascular repair for thoracic aortic pathology (32 aneurysms, 17 acute thoracic aortic syndromes, and six traumatic aortic ruptures) during a six-year period were retrospectively reviewed. From these patients, 30 (54.5%) were treated electively and 25 (45.5%) on an emergency basis. In eight cases (14.5%) there was a need for left subclavian artery orifice overstenting. In seven patients (12.7%) an abdominal aortic lesion was simultaneously treated, while three more patients (5.5%) had previously had their abdominal aortic aneurysm repaired. RESULTS: The primary technical success was 92.7%. Seven patients (12.7%) underwent some operation related complication, while postoperative complications occurred in five patients (9.1%), namely four myocardial infarctions, one acute respiratory distress syndrome and two delayed parapareses resulting in an overall incidence of neurological complications of 3.6%. The combined 30-day and in-hospital mortality was 9.1%, exclusively related to patients treated emergently (P = 0.01). In a mean follow-up period of 34 months there were six deaths, and the overall cumulative survival at four years was estimated at 72.6%. Only one type II endoleak was observed one month after the procedure and it spontaneously disappeared 18 months later. CONCLUSIONS: The endovascular repair of descending thoracic aortic pathologies seems to be a well-established method, with favorable morbidity and mortality rates, at least for 30 days and in the mid-term. Taking into account the potential of a wide application of the endovascular technique in many vascular centers, stenting of the thoracic aorta might offer an overall better solution for patients suffering from these devastating pathologies.
|Institution and School/Department of submitter:||Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής|
|Keywords:||Adolescent,Adult,Aged,Aged, 80 and over,Aorta, Thoracic/radiography/*surgery,Aortic Diseases/mortality/radiography/*surgery,Aortography/methods,*Blood Vessel Prosthesis,Blood Vessel Prosthesis Implantation/adverse effects/*instrumentation/mortality,Chi-Square Distribution,Endovascular Procedures/adverse effects/*instrumentation/mortality,Female,Greece,Hospital Mortality,Humans,Kaplan-Meier Estimate,Male,Middle Aged,Postoperative Complications/etiology,Prosthesis Design,Reoperation,Retrospective Studies,Risk Assessment,Risk Factors,*Stents,Time Factors,Tomography, X-Ray Computed,Treatment Outcome,Young Adult|
|Appears in Collections:||Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)|
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