Document Detail


Short and midterm results with minimally invasive endovascular repair of acute and chronic thoracic aortic pathology.
MedLine Citation:
PMID:  18381131     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Endovascular management of both acute and chronic thoracic aortic pathology has emerged as an alternative to open surgery. We reviewed our single center experience with endovascular devices for the treatment of thoracic aortic pathology.
METHODS: Between April 2000 and October 2007, 116 thoracic aortic stent grafts were placed to treat a variety of acute or chronic thoracic aortic lesions. Thirty-five percent of the cases were performed emergently. Sixty-five percent of the patients were male; the average age was 63.9 years (range 20-93 years). Indications for treatment were chronic degenerative aneurysms (n = 70), traumatic aortic disruption (n = 20), complicated dissection, intramural hematoma, or penetrating aortic ulcer (n = 14), pseudoaneurysm (n = 10), and Diverticulum of Kommerell (n = 2). Arch vessel revascularization (n = 32) or mesenteric debranching (n = 7) was performed in select cases. Devices used were industry-approved thoracic aortic devices (n = 80), aortic cuff extenders (n = 19), or custom made by the surgeon (n = 17).
RESULTS: The 30-day death, stroke and paraplegia/paresis rates were 5.2%, 8.6%, and 2.6%, respectively. Arterial access complications requiring immediate operative repair occurred at a rate of 11.2% (n = 13). The endoleak rate requiring repeat intervention was 6.9% (n = 8). The delayed graft infection rate was 5.2% (n = 6), with four of these cases resulting in death. The mean follow-up is 15 months (range 1-78 months). Computed tomography angiograms were performed at 1, 6, and 12 months following the index procedure, and yearly thereafter.
CONCLUSIONS: Endovascular therapy for acute and chronic thoracic aortic pathology is a viable alternative to open surgery with comparable operative morbidity and mortality. Midterm results suggest that endografts are durable, but require more secondary interventions and imaging surveillance than open reconstruction.
Authors:
Katherine E Brown; Mark K Eskandari; Jon S Matsumura; Heron Rodriguez; Mark D Morasch
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  47     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-02     Completed Date:  2008-05-13     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  714-22; Discussion 722-3     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Northwestern University, Chicago, IL 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / surgery
Aorta, Thoracic*
Aortic Aneurysm, Thoracic / surgery
Aortic Diseases / radiography,  surgery*
Chronic Disease
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Surgical Procedures, Minimally Invasive*
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / methods

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


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