Document Detail


TEVAR for non-aneurysmal thoracic aortic pathology.
MedLine Citation:
PMID:  19496139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Management of penetrating atherosclerotic ulcers (PAU), intramural hematomas (IMH), and acute aortic dissections (AD) of the thoracic aorta remain controversial in the endovascular era. METHODS: Between 2001 and 2007, patients with PAU (13 patients), and/or IMH (7 patients) were treated with thoracic endografts (TEVAR) in the endovascular suite under general anesthesia. Indications for intervention were intractable chest pain, expanding hematoma or contained rupture, or distal malperfusion. End-points were early morbidity and mortality, incidence of endoleak, device-related complications, and secondary interventions. RESULTS: Of the 20 patients with a median age of 67 (25-83), 13 (65%) were men, 2 (10%) had contained aortic rupture, and 10 were symptomatic. One patient had carotid-subclavian bypass debranching before endograft implantation. Ten patients had cerebrospinal fluid drainage. Mean length of aorta treated was 122.1 mm (range 36-300). All endografts were technically successful. Average blood loss was 50 mL. Thirty-day mortality was 0%. Symptoms resolved in all patients; there were no neurologic complications. Average length of stay was 5 days. Mean follow-up was 2.0 years (range 0.1-5.8). All patients remained asymptomatic. Three had early (<180 days) endoleaks: Two type II and 1 type I treated successfully with an additional cuff, which was the only patient requiring reintervention. Two patients had late (>180 days) endoleaks (type 2) observed with no aortic expansion. Two deaths at 5.4 and 5.8 years were due to severe aortic valve stenosis and metastatic lung cancer. CONCLUSION: TEVAR is a feasible option for repair of non-aneurysmal thoracic aortic pathology with resolution of symptoms, no mortality, and no neurologic complications.
Authors:
Sean D'Souza; Audra Duncan; Fernando Aguila; Gustavo Oderich; Joseph Ricotta; Manju Kalra; Peter Gloviczki; Thomas Bower; Thoralf Sundt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  783-6     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley-Liss, Inc.
Affiliation:
Mayo Clinic, USA. dsouza.sean@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aorta, Thoracic / radiography,  surgery*
Aortic Diseases / radiography,  surgery*
Aortic Rupture / surgery
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation
Female
Hematoma / surgery
Humans
Length of Stay
Male
Middle Aged
Prosthesis Design
Prosthesis Failure
Reoperation
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ulcer / surgery

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


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