Document Detail


Thoracic aortic aneurysm repair with endovascular stent-grafts.
MedLine Citation:
PMID:  9546963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the study was to describe the clinical experience is using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22-24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.
Authors:
C P Semba; R S Mitchell; D C Miller; N Kato; S T Kee; J T Chen; M D Dake
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  2     ISSN:  1358-863X     ISO Abbreviation:  Vasc Med     Publication Date:  1997  
Date Detail:
Created Date:  1998-04-14     Completed Date:  1998-04-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  98-103     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular-Interventional Radiology, Stanford University School of Medicine, CA 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Female
Humans
Male
Postoperative Complications / epidemiology,  mortality
Retrospective Studies
Stents*
Survival Analysis
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / instrumentation,  methods*

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


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