Document Detail

Long-term results of thoracic endovascular aortic repair in atherosclerotic aneurysms involving the descending aorta.
MedLine Citation:
PMID:  20650474     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study evaluated long-term results of thoracic endovascular aortic repair for atherosclerotic aneurysms involving descending aorta.
METHODS: One hundred thirteen patients underwent thoracic endovascular aortic repair for this indication from 1996 to 2009. Mean follow-up was 54 ± 38 months (5-144 months). In-hospital mortality, neurologic injury, need for rerouting, occurrence of endoleaks and their treatment, and survival were recorded.
RESULTS: In-hospital mortality was 5.3%. Transient neurologic injury rate was 2.6%. Previous rerouting was performed in 51%. Assisted early and late type I and III endoleak rates were 7.9% and 5.7%, respectively. Five percent of patients required late surgical conversion. Actuarial survivals were 86%, 60%, and 42% at 1, 5, and 10 years, respectively. Aorta-related actuarial survivals were 94%, 90%, and 83% at 1, 5, and 10 years, respectively. Cox regression analysis revealed higher number of prostheses as independent risk factor for early (hazard ratio, 5.38; 95% confidence interval, 1.68-42.37) and late (hazard ratio, 8.49; 95% confidence interval, 1.09-66.06) endoleak formation. Female sex (hazard ratio, 0.35; 95% confidence interval, 0.13-0.99), no arch involvement (hazard ratio, 0.21; 95% confidence interval, 0.05-0.08), and higher number of prostheses (hazard ratio, 7.95; 95% confidence interval, 1.36-46.58) affected survival.
CONCLUSIONS: Aorta-related survival is excellent among patients undergoing thoracic endovascular aortic repair for atherosclerotic aneurysms involving the descending aorta. Life-long surveillance remains mandatory, with early and late failure uncommon but still needing consideration. Thoracic endovascular aortic repair in this group of patients remains attractive and has now proven durability.
Martin Czerny; Martin Funovics; Gottfried Sodeck; Julia Dumfarth; Maria Schoder; Andrzej Juraszek; Tomasz Dziodzio; Daniel Zimpfer; Christian Loewe; Johannes Lammer; Raphael Rosenhek; Marek Ehrlich; Michael Grimm
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Publication Detail:
Type:  Journal Article     Date:  2010-07-21
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S179-84; discussion S185-S190     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland.
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MeSH Terms
Aortic Aneurysm, Thoracic / etiology,  mortality,  surgery*
Atherosclerosis / complications*
Blood Vessel Prosthesis Implantation* / adverse effects,  mortality
Chi-Square Distribution
Endoleak / etiology
Endovascular Procedures* / adverse effects,  mortality
Hospital Mortality
Kaplan-Meier Estimate
Proportional Hazards Models
Risk Assessment
Risk Factors
Survival Analysis
Time Factors
Trauma, Nervous System / etiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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