| Stent grafting for aneurysmal degeneration of chronic descending thoracic aortic dissections. | |
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MedLine Citation:
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PMID: 22244358 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to examine the results of thoracic endovascular aneurysm repair (TEVAR) for chronic descending thoracic aortic (DTA) dissections with aneurysmal degeneration. METHODS: Over 70 months at a single institution, 27 patients underwent TEVAR for aneurysms related to chronic (>6 weeks) DTA dissections. RESULTS: Mean patient age was 67.5 ± 9.6 years; 18 were men. Primary indications for repair were aneurysm size (n = 20), rapid aneurysmal growth (n = 5), saccular aneurysm (n = 1), and rupture (n = 1). Preoperative false lumen status was patent in 18 patients, partially thrombosed in 8 patients, and unknown in the patient whose aneurysm ruptured. The proximal entry tear was covered in all 27 patients. Fourteen patients required coverage of the left subclavian artery, of which 9 patients underwent prophylactic revascularization. On completion angiogram, no patient had antegrade perfusion of the aneurysmal false lumen. There were three procedural complications: 2 patients sustained paraparesis (one resolved and one improved), and 1 patient had an access injury requiring stent graft placement. Thirty-day mortality was 3.7% (1 of 27); the one death was in the patient whose aneurysm ruptured. Of the 26 surviving patients, 23 (88.5%) had thrombosis of the aneurysmal false lumen. Twenty-two patients (84.6%) had stability or decrease in maximal aneurysm diameter on last radiographic follow-up at 18 ± 20 months. Three-year Kaplan-Meier survival was 90.3% ± 6.5% in the 26 patients who survived to hospital discharge, with a mean follow-up of 27.3 ± 22.1 months. In patients with preoperatively partially thrombosed false lumens (n = 8), 3-year survival was 100%. CONCLUSIONS: TEVAR for aneurysms due to chronic dissections of the DTA can be performed safely and effectively at midterm follow-up according to this single-institution study. Stent graft therapy may be of particular benefit in patients presenting with partially thrombosed false lumens. |
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Authors:
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Derek P Nathan; Edward Y Woo; Ronald M Fairman; Grace J Wang; Alberto Pochettino; Nimesh D Desai; Joseph E Bavaria; Benjamin M Jackson |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2012-01-11 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 55 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-02 Completed Date: 2012-05-30 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 963-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aneurysm, Dissecting / mortality*, radiography, surgery* Angioplasty / methods Aortic Aneurysm, Thoracic / mortality*, radiography, surgery* Blood Vessel Prosthesis Implantation / methods* Cause of Death* Chronic Disease Cohort Studies Female Follow-Up Studies Hospital Mortality / trends Humans Kaplan-Meier Estimate Male Middle Aged Postoperative Complications / mortality, physiopathology Proportional Hazards Models Retrospective Studies Risk Assessment Severity of Illness Index Stents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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